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Peremiquel-Trillas P, Paytubi S, Pelegrina B, Frias-Gomez J, Carmona Á, Martínez JM, de Francisco J, Benavente Y, Barahona M, Briansó F, Canet-Hermida J, Caño V, Vidal A, Zanca A, Baixeras N, Rodríguez A, Fernández-Gonzalez S, Dueñas N, Càrdenas L, Aytés Á, Bianchi I, Pavón MÀ, Reventós J, Capellà G, Gómez D, Diaz M, Ponce J, Brunet J, Matias-Guiu X, Bosch FX, de Sanjosé S, Alemany L, Pineda M, Marin F, Costas L. An Integrated Approach for the Early Detection of Endometrial and Ovarian Cancers (Screenwide Study): Rationale, Study Design and Pilot Study. J Pers Med 2022; 12:jpm12071074. [PMID: 35887570 PMCID: PMC9324683 DOI: 10.3390/jpm12071074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/23/2022] [Accepted: 06/27/2022] [Indexed: 11/21/2022] Open
Abstract
Screenwide is a case-control study (2017−2021) including women with incident endometrial and ovarian cancers (EC and OC), BRCA1/2 and MMR pathogenic variant carriers, and age-matched controls from three centers in Spain. Participants completed a personal interview on their sociodemographic factors, occupational exposure, medication, lifestyle, and medical history. We collected biological specimens, including blood samples, self-collected vaginal specimens, cervical pap-brush samples, uterine specimens, and, when available, tumor samples. The planned analyses included evaluation of the potential risk factors for EC/OC; evaluation of molecular biomarkers in minimally invasive samples; evaluation of the cost-effectiveness of molecular tests; and the generation of predictive scores to integrate different epidemiologic, clinical, and molecular factors. Overall, 182 EC, 69 OC, 98 BRCA pathogenic variant carriers, 104 MMR pathogenic variant carriers, and 385 controls were enrolled. The overall participation rate was 85.7%. The pilot study using 61 samples from nine EC cases and four controls showed that genetic variants at the variant allele fraction > 5% found in tumors (n = 61 variants across the nine tumors) were detected in paired endometrial aspirates, clinician-collected cervical samples, and vaginal self-samples with detection rates of 90% (55/61), 79% (48/61), and 72% (44/61) by duplex sequencing, respectively. Among the controls, only one somatic mutation was detected in a cervical sample. We enrolled more than 800 women to evaluate new early detection strategies. The preliminary data suggest that our methodological approach could be useful for the early detection of gynecological cancers.
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Affiliation(s)
- Paula Peremiquel-Trillas
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, IDIBELL, l’Hospitalet de Llobregat, 08908 Barcelona, Spain; (P.P.-T.); (S.P.); (B.P.); (J.F.-G.); (Á.C.); (Y.B.); (M.À.P.); (D.G.); (M.D.); (F.X.B.); (L.A.)
- Faculty of Medicine, University of Barcelona, 08036 Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health-CIBERESP, Carlos III Institute of Health, 28029 Madrid, Spain;
| | - Sonia Paytubi
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, IDIBELL, l’Hospitalet de Llobregat, 08908 Barcelona, Spain; (P.P.-T.); (S.P.); (B.P.); (J.F.-G.); (Á.C.); (Y.B.); (M.À.P.); (D.G.); (M.D.); (F.X.B.); (L.A.)
| | - Beatriz Pelegrina
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, IDIBELL, l’Hospitalet de Llobregat, 08908 Barcelona, Spain; (P.P.-T.); (S.P.); (B.P.); (J.F.-G.); (Á.C.); (Y.B.); (M.À.P.); (D.G.); (M.D.); (F.X.B.); (L.A.)
| | - Jon Frias-Gomez
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, IDIBELL, l’Hospitalet de Llobregat, 08908 Barcelona, Spain; (P.P.-T.); (S.P.); (B.P.); (J.F.-G.); (Á.C.); (Y.B.); (M.À.P.); (D.G.); (M.D.); (F.X.B.); (L.A.)
- Faculty of Medicine, University of Barcelona, 08036 Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health-CIBERESP, Carlos III Institute of Health, 28029 Madrid, Spain;
| | - Álvaro Carmona
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, IDIBELL, l’Hospitalet de Llobregat, 08908 Barcelona, Spain; (P.P.-T.); (S.P.); (B.P.); (J.F.-G.); (Á.C.); (Y.B.); (M.À.P.); (D.G.); (M.D.); (F.X.B.); (L.A.)
| | - José Manuel Martínez
- Department of Gynecology, IDIBELL, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, 08908 Barcelona, Spain; (J.M.M.); (M.B.); (S.F.-G.); (J.P.)
| | - Javier de Francisco
- Department of Anesthesiology, IDIBELL, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, 08908 Barcelona, Spain; (J.d.F.); (V.C.)
| | - Yolanda Benavente
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, IDIBELL, l’Hospitalet de Llobregat, 08908 Barcelona, Spain; (P.P.-T.); (S.P.); (B.P.); (J.F.-G.); (Á.C.); (Y.B.); (M.À.P.); (D.G.); (M.D.); (F.X.B.); (L.A.)
- Consortium for Biomedical Research in Epidemiology and Public Health-CIBERESP, Carlos III Institute of Health, 28029 Madrid, Spain;
| | - Marc Barahona
- Department of Gynecology, IDIBELL, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, 08908 Barcelona, Spain; (J.M.M.); (M.B.); (S.F.-G.); (J.P.)
| | - Ferran Briansó
- Department of Genetics, Microbiology and Statistics, Universitat de Barcelona, 08028 Barcelona, Spain;
- Roche Diagnostics, Sant Cugat del Vallès, 08174 Barcelona, Spain
| | - Júlia Canet-Hermida
- Hereditary Cancer Group, ONCOBELL Program, Catalan Institute of Oncology, IDIBELL, L’Hospitalet, 08908 Barcelona, Spain; (J.C.-H.); (N.D.); (G.C.); (J.B.); (M.P.); (F.M.)
- Consortium for Biomedical Research in Cancer–CIBERONC, Carlos III Institute of Health, 28029 Madrid, Spain; (A.V.); (X.M.-G.)
| | - Víctor Caño
- Department of Anesthesiology, IDIBELL, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, 08908 Barcelona, Spain; (J.d.F.); (V.C.)
| | - August Vidal
- Consortium for Biomedical Research in Cancer–CIBERONC, Carlos III Institute of Health, 28029 Madrid, Spain; (A.V.); (X.M.-G.)
- Department of Pathology, IDIBELL, Hospitalet de Llobregat, Hospital Universitari de Bellvitge, 08907 Barcelona, Spain; (A.Z.); (N.B.); (A.R.)
| | - Alba Zanca
- Department of Pathology, IDIBELL, Hospitalet de Llobregat, Hospital Universitari de Bellvitge, 08907 Barcelona, Spain; (A.Z.); (N.B.); (A.R.)
| | - Núria Baixeras
- Department of Pathology, IDIBELL, Hospitalet de Llobregat, Hospital Universitari de Bellvitge, 08907 Barcelona, Spain; (A.Z.); (N.B.); (A.R.)
| | - Axel Rodríguez
- Department of Pathology, IDIBELL, Hospitalet de Llobregat, Hospital Universitari de Bellvitge, 08907 Barcelona, Spain; (A.Z.); (N.B.); (A.R.)
| | - Sergi Fernández-Gonzalez
- Department of Gynecology, IDIBELL, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, 08908 Barcelona, Spain; (J.M.M.); (M.B.); (S.F.-G.); (J.P.)
| | - Núria Dueñas
- Hereditary Cancer Group, ONCOBELL Program, Catalan Institute of Oncology, IDIBELL, L’Hospitalet, 08908 Barcelona, Spain; (J.C.-H.); (N.D.); (G.C.); (J.B.); (M.P.); (F.M.)
- Consortium for Biomedical Research in Cancer–CIBERONC, Carlos III Institute of Health, 28029 Madrid, Spain; (A.V.); (X.M.-G.)
| | - Laura Càrdenas
- Department of Gynecology and Obstetrics, Hospital Universitari Dr. Josep Trueta, 17007 Girona, Spain;
| | - Álvaro Aytés
- Program against Cancer Therapeutic Resistance (ProCURE), IDIBELL, Hospitalet de Llobregat, 08908 Barcelona, Spain;
| | - Ilaria Bianchi
- ASSIR Delta, Serveis d’Atenció Primària Delta del Llobregat, Direcció d’Atenció Primària Costa de Ponent, Gerència Territorial Metropolitana Sud, Institut Català de la Salut, 08006 Barcelona, Spain;
| | - Miquel Àngel Pavón
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, IDIBELL, l’Hospitalet de Llobregat, 08908 Barcelona, Spain; (P.P.-T.); (S.P.); (B.P.); (J.F.-G.); (Á.C.); (Y.B.); (M.À.P.); (D.G.); (M.D.); (F.X.B.); (L.A.)
- Consortium for Biomedical Research in Epidemiology and Public Health-CIBERESP, Carlos III Institute of Health, 28029 Madrid, Spain;
| | - Jaume Reventós
- Departament de Ciències Bàsiques, Universitat Internacional de Catalunya, 08017 Barcelona, Spain;
| | - Gabriel Capellà
- Hereditary Cancer Group, ONCOBELL Program, Catalan Institute of Oncology, IDIBELL, L’Hospitalet, 08908 Barcelona, Spain; (J.C.-H.); (N.D.); (G.C.); (J.B.); (M.P.); (F.M.)
- Consortium for Biomedical Research in Cancer–CIBERONC, Carlos III Institute of Health, 28029 Madrid, Spain; (A.V.); (X.M.-G.)
| | - David Gómez
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, IDIBELL, l’Hospitalet de Llobregat, 08908 Barcelona, Spain; (P.P.-T.); (S.P.); (B.P.); (J.F.-G.); (Á.C.); (Y.B.); (M.À.P.); (D.G.); (M.D.); (F.X.B.); (L.A.)
| | - Mireia Diaz
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, IDIBELL, l’Hospitalet de Llobregat, 08908 Barcelona, Spain; (P.P.-T.); (S.P.); (B.P.); (J.F.-G.); (Á.C.); (Y.B.); (M.À.P.); (D.G.); (M.D.); (F.X.B.); (L.A.)
- Consortium for Biomedical Research in Epidemiology and Public Health-CIBERESP, Carlos III Institute of Health, 28029 Madrid, Spain;
| | - Jordi Ponce
- Department of Gynecology, IDIBELL, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, 08908 Barcelona, Spain; (J.M.M.); (M.B.); (S.F.-G.); (J.P.)
| | - Joan Brunet
- Hereditary Cancer Group, ONCOBELL Program, Catalan Institute of Oncology, IDIBELL, L’Hospitalet, 08908 Barcelona, Spain; (J.C.-H.); (N.D.); (G.C.); (J.B.); (M.P.); (F.M.)
- Consortium for Biomedical Research in Cancer–CIBERONC, Carlos III Institute of Health, 28029 Madrid, Spain; (A.V.); (X.M.-G.)
- Medical Oncology Department, Catalan Institute of Oncology, Doctor Josep Trueta Girona University Hospital, 17007 Girona, Spain
| | - Xavier Matias-Guiu
- Consortium for Biomedical Research in Cancer–CIBERONC, Carlos III Institute of Health, 28029 Madrid, Spain; (A.V.); (X.M.-G.)
- Department of Pathology, IDIBELL, Hospitalet de Llobregat, Hospital Universitari de Bellvitge, 08907 Barcelona, Spain; (A.Z.); (N.B.); (A.R.)
| | - Francesc Xavier Bosch
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, IDIBELL, l’Hospitalet de Llobregat, 08908 Barcelona, Spain; (P.P.-T.); (S.P.); (B.P.); (J.F.-G.); (Á.C.); (Y.B.); (M.À.P.); (D.G.); (M.D.); (F.X.B.); (L.A.)
- Consortium for Biomedical Research in Epidemiology and Public Health-CIBERESP, Carlos III Institute of Health, 28029 Madrid, Spain;
- Universitat Oberta de Catalunya, 08018 Barcelona, Spain
| | - Silvia de Sanjosé
- Consortium for Biomedical Research in Epidemiology and Public Health-CIBERESP, Carlos III Institute of Health, 28029 Madrid, Spain;
- Consultant, National Cancer Institute, Bethesda, MA 20814, USA
| | - Laia Alemany
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, IDIBELL, l’Hospitalet de Llobregat, 08908 Barcelona, Spain; (P.P.-T.); (S.P.); (B.P.); (J.F.-G.); (Á.C.); (Y.B.); (M.À.P.); (D.G.); (M.D.); (F.X.B.); (L.A.)
- Consortium for Biomedical Research in Epidemiology and Public Health-CIBERESP, Carlos III Institute of Health, 28029 Madrid, Spain;
| | - Marta Pineda
- Hereditary Cancer Group, ONCOBELL Program, Catalan Institute of Oncology, IDIBELL, L’Hospitalet, 08908 Barcelona, Spain; (J.C.-H.); (N.D.); (G.C.); (J.B.); (M.P.); (F.M.)
- Consortium for Biomedical Research in Cancer–CIBERONC, Carlos III Institute of Health, 28029 Madrid, Spain; (A.V.); (X.M.-G.)
| | - Fátima Marin
- Hereditary Cancer Group, ONCOBELL Program, Catalan Institute of Oncology, IDIBELL, L’Hospitalet, 08908 Barcelona, Spain; (J.C.-H.); (N.D.); (G.C.); (J.B.); (M.P.); (F.M.)
- Consortium for Biomedical Research in Cancer–CIBERONC, Carlos III Institute of Health, 28029 Madrid, Spain; (A.V.); (X.M.-G.)
| | - Laura Costas
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, IDIBELL, l’Hospitalet de Llobregat, 08908 Barcelona, Spain; (P.P.-T.); (S.P.); (B.P.); (J.F.-G.); (Á.C.); (Y.B.); (M.À.P.); (D.G.); (M.D.); (F.X.B.); (L.A.)
- Consortium for Biomedical Research in Epidemiology and Public Health-CIBERESP, Carlos III Institute of Health, 28029 Madrid, Spain;
- Correspondence:
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Ma JE, Grubber J, Coffman CJ, Wang V, Hastings SN, Allen KD, Shepherd-Banigan M, Decosimo K, Dadolf J, Sullivan C, Sperber NR, Van Houtven CH. Identifying family and unpaid caregivers in the electronic health record: A descriptive analysis (Preprint). JMIR Form Res 2021; 6:e35623. [PMID: 35849430 PMCID: PMC9345058 DOI: 10.2196/35623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 03/08/2022] [Accepted: 04/22/2022] [Indexed: 11/30/2022] Open
Abstract
Background Most efforts to identify caregivers for research use passive approaches such as self-nomination. We describe an approach in which electronic health records (EHRs) can help identify, recruit, and increase diverse representations of family and other unpaid caregivers. Objective Few health systems have implemented systematic processes for identifying caregivers. This study aimed to develop and evaluate an EHR-driven process for identifying veterans likely to have unpaid caregivers in a caregiver survey study. We additionally examined whether there were EHR-derived veteran characteristics associated with veterans having unpaid caregivers. Methods We selected EHR home- and community-based referrals suggestive of veterans’ need for supportive care from friends or family. We identified veterans with these referrals across the 8 US Department of Veteran Affairs medical centers enrolled in our study. Phone calls to a subset of these veterans confirmed whether they had a caregiver, specifically an unpaid caregiver. We calculated the screening contact rate for unpaid caregivers of veterans using attempted phone screening and for those who completed phone screening. The veteran characteristics from the EHR were compared across referral and screening groups using descriptive statistics, and logistic regression was used to compare the likelihood of having an unpaid caregiver among veterans who completed phone screening. Results During the study period, our EHR-driven process identified 12,212 veterans with home- and community-based referrals; 2134 (17.47%) veteran households were called for phone screening. Among the 2134 veterans called, 1367 (64.06%) answered the call, and 813 (38.1%) veterans had a caregiver based on self-report of the veteran, their caregiver, or another person in the household. The unpaid caregiver identification rate was 38.1% and 59.5% among those with an attempted phone screening and completed phone screening, respectively. Veterans had increased odds of having an unpaid caregiver if they were married (adjusted odds ratio [OR] 2.69, 95% CI 1.68-4.34), had respite care (adjusted OR 2.17, 95% CI 1.41-3.41), or had adult day health care (adjusted OR 3.69, 95% CI 1.60-10.00). Veterans with a dementia diagnosis (adjusted OR 1.37, 95% CI 1.00-1.89) or veteran-directed care referral (adjusted OR 1.95, 95% CI 0.97-4.20) were also suggestive of an association with having an unpaid caregiver. Conclusions The EHR-driven process to identify veterans likely to have unpaid caregivers is systematic and resource intensive. Approximately 60% (813/1367) of veterans who were successfully screened had unpaid caregivers. In the absence of discrete fields in the EHR, our EHR-driven process can be used to identify unpaid caregivers; however, incorporating caregiver identification fields into the EHR would support a more efficient and systematic identification of caregivers. Trial Registration ClincalTrials.gov NCT03474380; https://clinicaltrials.gov/ct2/show/NCT03474380
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Affiliation(s)
- Jessica E Ma
- Geriatric Research, Education, and Clinical Center, Durham Veterans Affairs Health Care System, Durham, NC, United States
- Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC, United States
| | - Janet Grubber
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC, United States
| | - Cynthia J Coffman
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC, United States
- Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, United States
| | - Virginia Wang
- Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC, United States
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC, United States
- Department of Population Health Sciences, Duke University, Durham, NC, United States
- Duke-Margolis Center for Health Policy, Duke University, Durham, NC, United States
| | - S Nicole Hastings
- Geriatric Research, Education, and Clinical Center, Durham Veterans Affairs Health Care System, Durham, NC, United States
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC, United States
- Department of Population Health Sciences, Duke University, Durham, NC, United States
- Center for the Study of Aging, Duke University School of Medicine, Durham, NC, United States
- Division of Geriatrics, Department of Medicine, Duke University School of Medicine, Durham, NC, United States
| | - Kelli D Allen
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC, United States
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Megan Shepherd-Banigan
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC, United States
- Department of Population Health Sciences, Duke University, Durham, NC, United States
| | - Kasey Decosimo
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC, United States
| | - Joshua Dadolf
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC, United States
| | - Caitlin Sullivan
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC, United States
| | - Nina R Sperber
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC, United States
- Department of Population Health Sciences, Duke University, Durham, NC, United States
| | - Courtney H Van Houtven
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC, United States
- Department of Population Health Sciences, Duke University, Durham, NC, United States
- Duke-Margolis Center for Health Policy, Duke University, Durham, NC, United States
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Airoldi C, Ferrante D, Mirabelli D, Azzolina D, Magnani C. Evaluation of Nonresponse Bias in a Case-Control Study of Pleural Mesothelioma. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176146. [PMID: 32847019 PMCID: PMC7504238 DOI: 10.3390/ijerph17176146] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/19/2020] [Accepted: 08/20/2020] [Indexed: 11/22/2022]
Abstract
Nonparticipation limits the power of epidemiological studies, and can cause bias. In a case–control study on pleural malignant mesothelioma (MM), we found low participation in interviews (63%) among controls. Our goal was to characterize nonresponder controls and assess nonresponse bias in our study. We selected all nonresponder controls (204) and a random sample of responder controls (174). Data were obtained linking hospital admissions and town registrars, and concordance between sources was assessed. Nonresponse bias was evaluated using a logistic regression model applying the inverse probability weighting approach. The odds ratio (OR) for the status of the respondents was 0.61 (95% confidence interval (CI): 0.33–1.16) for controls aged 61–70, 0.37 (CI: 0.20–0.66) for those aged 71–80, and 0.40 (CI: 0.20–0.80) for those aged above 80 (reference group: ≤60 years). Controls with low education level had lower OR (0.47; CI: 0.26–0.84). After adjustment, the ORs for MM by categories of cumulative exposure to asbestos were similar to the unadjusted results, ranging from 4.6 (CI: 1.8–11.7) for cumulative exposures between 0.1 and 1 f/mL-y to 57.5 (CI: 20.2–163.9) above 10 f/mL-y. Responder controls were younger and had higher education level. Nevertheless, there was little evidence of bias from nonresponse in the risk estimates of MM.
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Affiliation(s)
- Chiara Airoldi
- Department of Translational Medicine, Unit of Medical Statistics and Cancer Epidemiology, University of Eastern Piedmont, CPO-Piedmont, 28100 Novara, Italy; (D.F.); (D.A.); (C.M.)
- Correspondence: ; Tel.: +39-0321-3732-183
| | - Daniela Ferrante
- Department of Translational Medicine, Unit of Medical Statistics and Cancer Epidemiology, University of Eastern Piedmont, CPO-Piedmont, 28100 Novara, Italy; (D.F.); (D.A.); (C.M.)
| | - Dario Mirabelli
- Department of Medical Sciences, Unit of Cancer Epidemiology, CPO Piemonte and University of Turin, 10126 Turin, Italy;
- Interdepartmental Centre G. Scansetti for Studies on Asbestos and other Toxic Particulates, University of Turin, 10125 Turin, Italy
| | - Danila Azzolina
- Department of Translational Medicine, Unit of Medical Statistics and Cancer Epidemiology, University of Eastern Piedmont, CPO-Piedmont, 28100 Novara, Italy; (D.F.); (D.A.); (C.M.)
| | - Corrado Magnani
- Department of Translational Medicine, Unit of Medical Statistics and Cancer Epidemiology, University of Eastern Piedmont, CPO-Piedmont, 28100 Novara, Italy; (D.F.); (D.A.); (C.M.)
- Interdepartmental Centre G. Scansetti for Studies on Asbestos and other Toxic Particulates, University of Turin, 10125 Turin, Italy
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Jaehn P, Rehling J, Klawunn R, Merz S, Holmberg C. Practice of reporting social characteristics when describing representativeness of epidemiological cohort studies - A rationale for an intersectional perspective. SSM Popul Health 2020; 11:100617. [PMID: 32685654 PMCID: PMC7358453 DOI: 10.1016/j.ssmph.2020.100617] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 05/20/2020] [Accepted: 06/15/2020] [Indexed: 01/12/2023] Open
Abstract
Representativeness has been defined as the degree of similarity of a study population compared to an external population. To characterize a study population, both health-related and social or demographic features should be considered according to current guidelines. However, little guidance is given on how to describe social complexity of study populations when aiming to conclude on representativeness. We argue that sociological concepts should inform characterizations of study populations in order to increase credibility of conclusions on representativeness. The concept of intersectionality suggests to conceptualize social location as a combination of characteristics such as sex/gender and ethnicity instead of focusing on each feature independently. To contextualize advantages of integrating the concept of intersectionality when investigating representativeness, we reviewed publications that described the baseline population of selected epidemiological cohort studies. Information on the applied methods to characterize the study population was extracted, as well as reported social characteristics. Nearly all reviewed studies reported descriptive statistics of the baseline population and response proportions. In most publications, study populations were characterized according to place of residence, age and sex/gender while other social characteristics were reported irregularly. Differential patterns of representativeness were revealed in analyses that stratified social characteristics by sex/gender or age. Furthermore, the included studies did not explicitly state the theoretical approach that underlay their description of the study population. Intersectionality might be particularly fruitful when applied to descriptions of representativeness, because this concept provides an understanding of social location that has been developed based on situated experiences of people at the intersection of multiple axes of social power relations. An intersectional perspective, hence, contributes to approximate social complexity of study populations and might contribute to increase validity of conclusions on representativeness of population-based studies.
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Affiliation(s)
- Philipp Jaehn
- Brandenburg Medical School Theodor Fontane, Institute of Social Medicine and Epidemiology, Hochstraße 15, 14770, Brandenburgan der Havel, Germany
| | - Julia Rehling
- Umweltbundesamt, Corrensplatz 1, 14195, Berlin, Germany
| | - Ronny Klawunn
- Brandenburg Medical School Theodor Fontane, Institute of Social Medicine and Epidemiology, Hochstraße 15, 14770, Brandenburgan der Havel, Germany
- Hannover Medical School, Institute for Epidemiology, Social Medicine, and Health Systems Research, - OE 5410 -, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Sibille Merz
- Brandenburg Medical School Theodor Fontane, Institute of Social Medicine and Epidemiology, Hochstraße 15, 14770, Brandenburgan der Havel, Germany
| | - Christine Holmberg
- Brandenburg Medical School Theodor Fontane, Institute of Social Medicine and Epidemiology, Hochstraße 15, 14770, Brandenburgan der Havel, Germany
- Faculty of Health Sciences, joint Faculty of the Brandenburg University of Technology Cottbus – Senftenberg, the Brandenburg Medical School Theodor Fontane and the University of Potsdam, Germany
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Linnenkamp U, Gontscharuk V, Brüne M, Chernyak N, Kvitkina T, Arend W, Fiege A, Schmitz-Losem I, Kruse J, Evers SMAA, Hiligsmann M, Hoffmann B, Andrich S, Icks A. Using statutory health insurance data to evaluate non-response in a cross-sectional study on depression among patients with diabetes in Germany. Int J Epidemiol 2020; 49:629-637. [PMID: 31990354 PMCID: PMC7266537 DOI: 10.1093/ije/dyz278] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 12/13/2019] [Accepted: 12/19/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Low response rates do not indicate poor representativeness of study populations if non-response occurs completely at random. A non-response analysis can help to investigate whether non-response is a potential source for bias within a study. METHODS A cross-sectional survey among a random sample of a health insurance population with diabetes (n = 3642, 58.9% male, mean age 65.7 years), assessing depression in diabetes, was conducted in 2013 in Germany. Health insurance data were available for responders and non-responders to assess non-response bias. The response rate was 51.1%. Odds ratios (ORs) for responses to the survey were calculated using logistic regression taking into consideration the depression diagnosis as well as age, sex, antihyperglycaemic medication, medication utilization, hospital admission and other comorbidities (from health insurance data). RESULTS Responders and non-responders did not differ in the depression diagnosis [OR 0.99, confidence interval (CI) 0.82-1.2]. Regardless of age and sex, treatment with insulin only (OR 1.73, CI 1.36-2.21), treatment with oral antihyperglycaemic drugs (OAD) only (OR 1.77, CI 1.49-2.09), treatment with both insulin and OAD (OR 1.91, CI 1.51-2.43) and higher general medication utilization (1.29, 1.10-1.51) were associated with responding to the survey. CONCLUSION We found differences in age, sex, diabetes treatment and medication utilization between responders and non-responders, which might bias the results. However, responders and non-responders did not differ in their depression status, which is the focus of the DiaDec study. Our analysis may serve as an example for conducting non-response analyses using health insurance data.
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Affiliation(s)
- Ute Linnenkamp
- Institute for Health Services Research and Health Economics, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Veronika Gontscharuk
- Institute for Health Services Research and Health Economics, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Manuela Brüne
- Institute for Health Services Research and Health Economics, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Nadezda Chernyak
- Institute for Health Services Research and Health Economics, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Tatjana Kvitkina
- Institute for Health Services Research and Health Economics, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Werner Arend
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Annett Fiege
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | | | - Johannes Kruse
- Clinic for Psychosomatic and Psychotherapy, University Clinic Gießen, Gießen, Germany
| | - Silvia M A A Evers
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Mickaël Hiligsmann
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Barbara Hoffmann
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Silke Andrich
- Institute for Health Services Research and Health Economics, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Andrea Icks
- Institute for Health Services Research and Health Economics, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
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Nielen JT, Driessen JH, Dagnelie PC, Boonen A, van den Bemt B, van Onzenoort HA, Neef C, Henry RM, Burden AM, Sep SJ, van der Kallen CJ, Schram MT, Schaper N, Stehouwer CD, Smits L, de Vries F. Drug utilization in the Maastricht Study: A comparison with nationwide data. Medicine (Baltimore) 2020; 99:e18524. [PMID: 31895787 PMCID: PMC6946313 DOI: 10.1097/md.0000000000018524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Within the southern region of the Netherlands, the Maastricht Study is an on-going observational prospective population-based cohort study that focuses on the etiology of Type 2 diabetes mellitus (T2DM). Representativeness of the participating population is a crucial but often an unknown factor in population-based cohort studies such as the Maastricht Study. We therefore aimed to assess the representativeness of the study population by comparing drug utilization of the participants of the Maastricht Study with the general population of the Netherlands.Since T2DM patients were oversampled in this study, a sampling method was applied in order to ensure a similar distribution of T2DM over the study population. Drug use in the study population was compared with drug use in the population of the Netherlands, using a Z-test to compare 2 independent proportions.In general, drug use in the study was similar compared with national data. However, in the age group 65 to 74 years total drug use was lower in the study population (833/1000 persons) versus nationwide data (882/1000 persons). The use of pulmonary medications was lower (104/1000 persons vs 141/1000 persons) and the use of hypnotics/anxiolytics was higher (90/1000 persons vs 36/1000 persons) in the Maastricht Study as compared with national data.Drug use in the Maastricht Study population is largely comparable to that in the total Dutch population aged 45 to 74. Therefore, data on drug use by participants in the Maastricht Study can be used to perform studies assessing outcomes associated with drug use.
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Affiliation(s)
- Johannes T.H. Nielen
- Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Center +
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht
| | - Johanna H.M. Driessen
- Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Center +
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht
- School for nutrition, and translational research in metabolism (NUTRIM), Maastricht University
| | - Pieter C. Dagnelie
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht
- Department of Epidemiology, Maastricht University
- School for Public Health and Primary Care (CAPHRI), Maastricht University
| | - Annelies Boonen
- School for Public Health and Primary Care (CAPHRI), Maastricht University
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center +, Maastricht
| | - Bart van den Bemt
- Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Center +
- Department of Pharmacy, Sint Maartenskliniek
- Department of Pharmacy, Radboud University Medical Center, Nijmegen
| | - Hein A.W. van Onzenoort
- Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Center +
- Department of Clinical Pharmacy, Amphia Hospital, Breda
| | - Cees Neef
- Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Center +
| | - Ronald M.A. Henry
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht
- Department of Internal Medicine, Maastricht University Medical Center +, Maastricht, The Netherlands
| | - Andrea M. Burden
- Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Center +
- Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, Eidgenossische Technische Hochschule Zurich, Zurich, Switzerland
| | - Simone J.S. Sep
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht
- Department of Internal Medicine, Maastricht University Medical Center +, Maastricht, The Netherlands
| | - Carla J. van der Kallen
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht
- Department of Internal Medicine, Maastricht University Medical Center +, Maastricht, The Netherlands
| | - Miranda T. Schram
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht
- Department of Internal Medicine, Maastricht University Medical Center +, Maastricht, The Netherlands
| | - Nicolaas Schaper
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht
- Department of Epidemiology, Maastricht University
- Department of Internal Medicine, Maastricht University Medical Center +, Maastricht, The Netherlands
| | - Coen D.A. Stehouwer
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht
- Department of Epidemiology, Maastricht University
- Department of Internal Medicine, Maastricht University Medical Center +, Maastricht, The Netherlands
| | - Luc Smits
- Department of Epidemiology, Maastricht University
| | - Frank de Vries
- Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Center +
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht
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Enzenbach C, Wicklein B, Wirkner K, Loeffler M. Evaluating selection bias in a population-based cohort study with low baseline participation: the LIFE-Adult-Study. BMC Med Res Methodol 2019; 19:135. [PMID: 31262266 PMCID: PMC6604357 DOI: 10.1186/s12874-019-0779-8] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 06/18/2019] [Indexed: 12/30/2022] Open
Abstract
Background Participation in epidemiologic studies is steadily declining, which may result in selection bias. It is therefore an ongoing challenge to clarify the determinants of participation to judge possible selection effects and to derive measures to minimise that bias. We evaluated the potential for selection bias in a recent population-based cohort study with low baseline participation and investigated reasons for nonparticipation. Methods LIFE-Adult is a cohort study in the general population of the city of Leipzig (Germany) designed to gain insights into the distribution and development of civilisation diseases. Nine thousand one hundred forty-five participants aged 40–79 years were randomly sampled in 2011–2014. We compared LIFE-Adult participants with both the Leipzig population and nonparticipants using official statistics and short questionnaire data. We applied descriptive statistics and logistic regression analysis to evaluate the determinants of study participation. Results Thirty-one percent of the invited persons participated in the LIFE-Adult baseline examination. Study participants were less often elderly women and more often married, highly educated, employed, and current nonsmokers compared to both the Leipzig population and nonparticipants. They further reported better health than nonparticipants. The observed differences were considerable in education and health variables. They were generally stronger in men than in women. For example, in male study participants aged 50–69, the frequency of high education was 1.5 times that of the general population, and the frequency of myocardial infarction was half that of nonparticipants. Lack of time and interest, as well as health problems were the main reasons for nonparticipation. Conclusions Our investigation suggests that the low baseline participation in LIFE-Adult is associated with the typical selection of study participants with higher social status and healthier lifestyle, and additionally less disease. Notably, education and health status seem to be crucial selection factors. Consequently, frequencies of major health conditions in the general population will likely be underestimated. A differential selection related to sex might also distort effect estimates. The extent of the assessment, the interest in the research topic, and health problems of potential participants should in future be considered in LIFE-Adult and in similar studies to raise participation and to minimise selection bias. Electronic supplementary material The online version of this article (10.1186/s12874-019-0779-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Cornelia Enzenbach
- Institute for Medical Informatics, Statistics, and Epidemiology, University of Leipzig, Haertelstrasse 16-18, 04107, Leipzig, Germany. .,LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany.
| | - Barbara Wicklein
- Institute for Medical Informatics, Statistics, and Epidemiology, University of Leipzig, Haertelstrasse 16-18, 04107, Leipzig, Germany
| | - Kerstin Wirkner
- LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany
| | - Markus Loeffler
- Institute for Medical Informatics, Statistics, and Epidemiology, University of Leipzig, Haertelstrasse 16-18, 04107, Leipzig, Germany.,LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany
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8
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Andrich S, Ritschel M, Meyer G, Hoffmann F, Stephan A, Baltes M, Blessin J, Jobski K, Fassmer AM, Haastert B, Gontscharuk V, Arend W, Theunissen L, Colley D, Hinze R, Thelen S, Fuhrmann P, Sorg CGG, Windolf J, Rupprecht CJ, Icks A. Healthcare provision, functional ability and quality of life after proximal femoral fracture - 'ProFem': Study protocol of a population-based, prospective study based on individually linked survey and statutory health insurance data. BMJ Open 2019; 9:e028144. [PMID: 31243034 PMCID: PMC6597653 DOI: 10.1136/bmjopen-2018-028144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Proximal femoral fractures (PFF) are among the most frequent fractures in older people. However, the situation of people with a PFF after hospital discharge is poorly understood. Our aim is to (1) analyse healthcare provision, (2) examine clinical and patient-reported outcomes (PROs), (3) describe clinical and sociodemographic predictors of these and (4) develop an algorithm to identify subgroups with poor outcomes and a potential need for more intensive healthcare. METHODS AND ANALYSIS This is a population-based prospective study based on individually linked survey and statutory health insurance (SHI) data. All people aged minimum 60 years who have been continuously insured with the AOK Rheinland/Hamburg and experience a PFF within 1 year will be consecutively included (SHI data analysis). Additionally, 700 people selected randomly from the study population will be consecutively invited to participate in the survey. Questionnaire data will be collected in the participants' private surroundings at 3, 6 and 12 months after hospital discharge. If the insured person considers themselves to be only partially or not at all able to take part in the survey, a proxy person will be interviewed where possible. SHI variables include healthcare provision, healthcare costs and clinical outcomes. Questionnaire variables include information on PROs, lifestyle characteristics and socioeconomic status. We will use multiple regression models to estimate healthcare processes and outcomes including mortality and cost, investigate predictors, perform non-responder analysis and develop an algorithm to identify vulnerable subgroups. ETHICS AND DISSEMINATION The study was approved by the ethics committee of the Faculty of Medicine, Heinrich-Heine-University Düsseldorf (approval reference 6128R). All participants including proxies providing written and informed consent can withdraw from the study at any time. The study findings will be disseminated through scientific journals and public information. TRIAL REGISTRATION NUMBER DRKS00012554.
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Affiliation(s)
- Silke Andrich
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research at the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Michaela Ritschel
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Gabriele Meyer
- Martin Luther University Halle-Wittenberg, Institute for Health and Nursing Sciences, Medical Faculty, Halle (Saale), Germany
| | - Falk Hoffmann
- Department of Health Services Research, Faculty of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Germany
| | - Astrid Stephan
- Martin Luther University Halle-Wittenberg, Institute for Health and Nursing Sciences, Medical Faculty, Halle (Saale), Germany
| | - Marion Baltes
- Martin Luther University Halle-Wittenberg, Institute for Health and Nursing Sciences, Medical Faculty, Halle (Saale), Germany
| | - Juliane Blessin
- Martin Luther University Halle-Wittenberg, Institute for Health and Nursing Sciences, Medical Faculty, Halle (Saale), Germany
| | - Kathrin Jobski
- Department of Health Services Research, Faculty of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Germany
| | - Alexander M Fassmer
- Department of Health Services Research, Faculty of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Germany
| | - Burkhard Haastert
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- mediStatistica, Neuenrade, Germany
| | - Veronika Gontscharuk
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Werner Arend
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Lena Theunissen
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Denise Colley
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Raoul Hinze
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Simon Thelen
- Department of Trauma and Hand Surgery, University Hospital Düsseldorf, Germany
| | - Petra Fuhrmann
- Department Health Policy – Health Economics – Press Relations, AOK Rheinland/Hamburg, Düsseldorf, Germany
| | - Christian G G Sorg
- Department Health Policy – Health Economics – Press Relations, AOK Rheinland/Hamburg, Düsseldorf, Germany
| | - Joachim Windolf
- Department of Trauma and Hand Surgery, University Hospital Düsseldorf, Germany
| | - Christoph J Rupprecht
- Department Health Policy – Health Economics – Press Relations, AOK Rheinland/Hamburg, Düsseldorf, Germany
| | - Andrea Icks
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research at the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
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Spiers S, Oral E, Fontham ETH, Peters ES, Mohler JL, Bensen JT, Brennan CS. Modelling attrition and nonparticipation in a longitudinal study of prostate cancer. BMC Med Res Methodol 2018; 18:60. [PMID: 29925318 PMCID: PMC6011525 DOI: 10.1186/s12874-018-0518-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 06/06/2018] [Indexed: 11/28/2022] Open
Abstract
Background Attrition occurs when a participant fails to respond to one or more study waves. The accumulation of attrition over several waves can lower the sample size and power and create a final sample that could differ in characteristics than those who drop out. The main reason to conduct a longitudinal study is to analyze repeated measures; research subjects who drop out cannot be replaced easily. Our group recently investigated factors affecting nonparticipation (refusal) in the first wave of a population-based study of prostate cancer. In this study we assess factors affecting attrition in the second wave of the same study. We compare factors affecting nonparticipation in the second wave to the ones affecting nonparticipation in the first wave. Methods Information available on participants in the first wave was used to model attrition. Different sources of attrition were investigated separately. The overall and race-stratified factors affecting attrition were assessed. Kaplan-Meier survival curve estimates were calculated to assess the impact of follow-up time on participation. Results High cancer aggressiveness was the main predictor of attrition due to death or frailty. Higher Charlson Comorbidity Index increased the odds of attrition due to death or frailty only in African Americans (AAs). Young age at diagnosis for AAs and low income for European Americans (EAs) were predictors for attrition due to lost to follow-up. High cancer aggressiveness for AAs, low income for EAs, and lower patient provider communication scores for EAs were predictors for attrition due to refusal. These predictors of nonparticipation were not the same as those in wave 1. For short follow-up time, the participation probability of EAs was higher than that of AAs. Conclusions Predictors of attrition can vary depending on the attrition source. Examining overall attrition (combining all sources of attrition under one category) instead of distinguishing among its different sources should be avoided. The factors affecting attrition in one wave can be different in a later wave and should be studied separately.
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Affiliation(s)
- Samantha Spiers
- LSUHSC, School of Public Health, Biostatistics Program, New Orleans, USA
| | - Evrim Oral
- LSUHSC, School of Public Health, Biostatistics Program, New Orleans, USA.
| | | | - Edward S Peters
- LSUHSC, School of Public Health, Epidemiology Program, New Orleans, USA
| | - James L Mohler
- Department of Urology, Roswell Park Cancer Institute, Buffalo, USA.,Lineberger Comprehensive Cancer Center, UNC-Chapel Hill, Chapel Hill, USA
| | - Jeannette T Bensen
- Lineberger Comprehensive Cancer Center, UNC-Chapel Hill, Chapel Hill, USA
| | - Christine S Brennan
- LSUHSC, School of Public Health, Health Policy and Systems Management Program, New Orleans, USA
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Green E, Bennett H, Brayne C, Matthews FE. Exploring patterns of response across the lifespan: the Cambridge Centre for Ageing and Neuroscience (Cam-CAN) study. BMC Public Health 2018; 18:760. [PMID: 29914423 PMCID: PMC6006958 DOI: 10.1186/s12889-018-5663-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 06/03/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND With declining rates of participation in epidemiological studies there is an important need to attempt to understand what factors might affect response. This study examines the pattern of response at different adult ages within a contemporary cross-sectional population-based cohort, the Cambridge Centre for Ageing and Neuroscience (Cam-CAN). METHODS Using logistic regression, we investigated associations between age, gender and Townsend deprivation level for both participants and non-participants. Weighted estimates of the odds ratios with confidence intervals for each demographic characteristic were calculated. Reasons given for refusal were grouped into three broad categories: 'active', 'passive' and illness preventing interview. RESULTS An association of age and participation was found, with individuals in middle age groups more likely to participate (age group 48-57 OR: 1.8, 95% CI: 1.5-2.2 and age group 58-67 OR: 2.1, 95% CI: 1.7-2.4). Overall, there was no difference in participation between men and women. An association with deprivation was found, with those living in the most deprived areas being the least willing to participate (fifth quintile OR: 0.6, 95% CI: 0.5-0.7). An interaction between age and gender was found whereby younger women and older men were more likely to agree to participate (p = 0.01). CONCLUSION Our findings highlight some of the factors affecting recruitment into epidemiological studies in the UK and suggest that targeted age-specific recruitment strategies might be needed to increase participation rates in future cohort investigations.
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Affiliation(s)
- Emma Green
- Department of Public Health and Primary Care, Cambridge Institute of Public Health, Cambridge, UK
- Institute of Public Health, Forvie Site, University of Cambridge School of Clinical Medicine, Box 113 Cambridge Biomedical Campus, Cambridge, CB2 0SR UK
| | - Holly Bennett
- Department of Public Health and Primary Care, Cambridge Institute of Public Health, Cambridge, UK
| | - Carol Brayne
- Department of Public Health and Primary Care, Cambridge Institute of Public Health, Cambridge, UK
| | - Fiona E. Matthews
- MRC Biostatistics Unit, Cambridge Institute of Public Health, Cambridge, UK
- Institute of Health and Society, Faculty of Medicine, Newcastle University, Newcastle, UK
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11
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Response rates in case-control studies of cancer by era of fieldwork and by characteristics of study design. Ann Epidemiol 2018; 28:385-391. [PMID: 29703520 DOI: 10.1016/j.annepidem.2018.04.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 02/14/2018] [Accepted: 04/03/2018] [Indexed: 11/22/2022]
Abstract
PURPOSE The purpose of this study was to describe time trends in response rates in case-control studies of cancer and identify study design factors that influence response rate. METHODS We reviewed 370 case-control studies of cancer published in 12 journals during indicator years in each of the last four decades. We estimated time trends of response rates and reasons for nonresponse in each of the following types of study subjects: cases, medical source controls, and population controls. We also estimated response rates according to characteristics of study context. RESULTS Median response rates among cases and population controls were between 75% and 80% in the 1970s. Between 1971 and 2010, study response rates declined by 0.31% per year for cases and 0.78% for population controls. Only a minority of studies reported reasons for nonparticipation; subject refusal was the most common reported reason. Studies conducted in North America had lower median response rates than studies conducted in Europe. In-person and telephone interviews elicited higher response rates than mail questionnaires. CONCLUSIONS Response rates from case-control studies of cancer have declined, and this could threaten the validity of results derived from these studies.
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12
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Zeissig SR, Weyer-Elberich V, Emrich K, Binder H, Fischbeck S, Imruck BH, Friedrich-Mai P, Beutel ME, Blettner M. Recruiting former melanoma patients via hospitals in comparison to office-based dermatologists in a register-based cohort study that required indirect contact. BMC Med Res Methodol 2017; 17:150. [PMID: 29166870 PMCID: PMC5700464 DOI: 10.1186/s12874-017-0425-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 11/14/2017] [Indexed: 11/17/2022] Open
Abstract
Background There are detailed reviews about different recruitment strategies, but not with regard to differences between recruitment of hospital-based versus office-based physicians. Within this study, the two different recruitment schemes are compared. Advantages and disadvantages of different ways of recruitment in registry-based studies are discussed. Methods In a cross-sectional cancer-registry-based study, long-term melanoma patients were contacted by dermatologists rather than directly by the registry on the basis of the legal situation. Logistic regression models and generalized estimating equations were used to assess effects of various patient and physician characteristics on participation and data quality. Especially differences between hospital-based versus office-based dermatologists are evaluated. Results Seventy two out of 112 contacted dermatologists took part in the study (64.3%). The cooperation proportion was 52.2% (689 participants/1320 contacted patients). Participants and non-participants differed regarding age and sex, but not regarding other social demographic factors and cancer stage. We did not observe a difference in patient participation between hospital-based versus office-based dermatologists (OR 1.08 [CI 0.84–1.39]; p = 0.57). However, medical data provided by the cancer registry were better for participants registered and recruited by hospitals. Conclusions In cohort studies with epidemiological cancer registries, recruitment via physicians has potential disadvantages and is more complex. If this indirect way of contact is mandatory, we recommend recruitment procedures including hospital-based rather than office-based physicians. However, physician characteristics were not associated with outcome.
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Affiliation(s)
- S R Zeissig
- Cancer Registry of Rhineland-Palatinate, Grosse Bleiche 46, 55116, Mainz, Germany. .,Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
| | - V Weyer-Elberich
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - K Emrich
- Cancer Registry of Rhineland-Palatinate, Grosse Bleiche 46, 55116, Mainz, Germany.,Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - H Binder
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - S Fischbeck
- Department of Psychosomatic Medicine and Psychotherapy, Medical Psychology and Medical Sociology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - B H Imruck
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - P Friedrich-Mai
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - M E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - M Blettner
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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13
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Sharafeldin N, Slattery ML, Liu Q, Franco-Villalobos C, Caan BJ, Potter JD, Yasui Y. Multiple Gene-Environment Interactions on the Angiogenesis Gene-Pathway Impact Rectal Cancer Risk and Survival. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14101146. [PMID: 28956832 PMCID: PMC5664647 DOI: 10.3390/ijerph14101146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Revised: 09/06/2017] [Accepted: 09/23/2017] [Indexed: 12/25/2022]
Abstract
Characterization of gene-environment interactions (GEIs) in cancer is limited. We aimed at identifying GEIs in rectal cancer focusing on a relevant biologic process involving the angiogenesis pathway and relevant environmental exposures: cigarette smoking, alcohol consumption, and animal protein intake. We analyzed data from 747 rectal cancer cases and 956 controls from the Diet, Activity and Lifestyle as a Risk Factor for Rectal Cancer study. We applied a 3-step analysis approach: first, we searched for interactions among single nucleotide polymorphisms on the pathway genes; second, we searched for interactions among the genes, both steps using Logic regression; third, we examined the GEIs significant at the 5% level using logistic regression for cancer risk and Cox proportional hazards models for survival. Permutation-based test was used for multiple testing adjustment. We identified 8 significant GEIs associated with risk among 6 genes adjusting for multiple testing: TNF (OR = 1.85, 95% CI: 1.10, 3.11), TLR4 (OR = 2.34, 95% CI: 1.38, 3.98), and EGR2 (OR = 2.23, 95% CI: 1.04, 4.78) with smoking; IGF1R (OR = 1.69, 95% CI: 1.04, 2.72), TLR4 (OR = 2.10, 95% CI: 1.22, 3.60) and EGR2 (OR = 2.12, 95% CI: 1.01, 4.46) with alcohol; and PDGFB (OR = 1.75, 95% CI: 1.04, 2.92) and MMP1 (OR = 2.44, 95% CI: 1.24, 4.81) with protein. Five GEIs were associated with survival at the 5% significance level but not after multiple testing adjustment: CXCR1 (HR = 2.06, 95% CI: 1.13, 3.75) with smoking; and KDR (HR = 4.36, 95% CI: 1.62, 11.73), TLR2 (HR = 9.06, 95% CI: 1.14, 72.11), EGR2 (HR = 2.45, 95% CI: 1.42, 4.22), and EGFR (HR = 6.33, 95% CI: 1.95, 20.54) with protein. GEIs between angiogenesis genes and smoking, alcohol, and animal protein impact rectal cancer risk. Our results support the importance of considering the biologic hypothesis to characterize GEIs associated with cancer outcomes.
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Affiliation(s)
- Noha Sharafeldin
- School of Public Health, University of Alberta, Edmonton, AB T6G 2R3, Canada.
- Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
| | - Martha L Slattery
- Department of Internal Medicine, University of Utah Health Sciences Center, Salt Lake City, UT 84132, USA.
| | - Qi Liu
- School of Public Health, University of Alberta, Edmonton, AB T6G 2R3, Canada.
| | | | - Bette J Caan
- Division of Research, Kaiser Permanente Medical Care Program, Oakland, CA 94612, USA.
| | - John D Potter
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA.
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA 98195, USA.
- Centre for Public Health Research, Massey University, P.O. Box 756, Wellington 6140, New Zealand.
| | - Yutaka Yasui
- School of Public Health, University of Alberta, Edmonton, AB T6G 2R3, Canada.
- Department of Epidemiology & Cancer Control, St. Jude Children's Research Hospital, Memphis, TN 38105, USA.
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14
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Nutrient patterns and chronic inflammation in a cohort of community dwelling middle-aged men. Clin Nutr 2017; 36:1040-1047. [DOI: 10.1016/j.clnu.2016.06.018] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Revised: 06/14/2016] [Accepted: 06/27/2016] [Indexed: 11/23/2022]
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15
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Participation in psychosocial oncology and quality-of-life research: a systematic review. Lancet Oncol 2017; 18:e153-e165. [DOI: 10.1016/s1470-2045(17)30100-6] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 10/27/2016] [Accepted: 10/27/2016] [Indexed: 11/20/2022]
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16
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Oral E, Simonsen N, Brennan C, Berken J, Su LJ, Mohler JL, Bensen JT, Fontham ETH. Unit Nonresponse in a Population-Based Study of Prostate Cancer. PLoS One 2016; 11:e0168364. [PMID: 27992587 PMCID: PMC5161356 DOI: 10.1371/journal.pone.0168364] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Accepted: 11/30/2016] [Indexed: 11/18/2022] Open
Abstract
Low unit response rates can increase bias and compromise study validity. Response rates have continued to fall over the past decade despite all efforts to increase participation. Many factors have been linked to reduced response, yet relatively few studies have employed multivariate approaches to identify characteristics that differentiate respondents from nonrespondents since it is hard to collect information on the latter. We aimed to assess factors contributing to enrollment of prostate cancer (PCa) patients. We combined data from the North Carolina-Louisiana (LA) PCa Project's LA cohort, with additional sources such as US census tract and LA tumor registry data. We included specific analyses focusing on blacks, a group often identified as hard to enroll in health-related research. The ability to study the effect of Hurricane Katrina, which occurred amidst enrollment, as a potential determinant of nonresponse makes our study unique. Older age (≥ 70) for blacks (OR 0.65) and study phase with respect to Hurricane Katrina for both races (OR 0.59 for blacks, OR 0.48 for whites) were significant predictors of participation with lower odds. Neighborhood poverty for whites (OR 1.53) also was a significant predictor of participation, but with higher odds. Among blacks, residence in Orleans parish was associated with lower odds of participation (OR 0.33) before Katrina. The opposite occurred in whites, with lower odds (OR 0.43) after Katrina. Our results overall underscore the importance of tailoring enrollment approaches to specific target population characteristics to confront the challenges posed by nonresponse. Our results also show that recruitment-related factors may change when outside forces bring major alterations to a population's environment and demographics.
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Affiliation(s)
- Evrim Oral
- Biostatistics Program, LSUHSC School of Public Health, New Orleans, Louisiana, United States of America
- * E-mail:
| | - Neal Simonsen
- Consultant Epidemiologist, New Orleans, Louisiana, United States of America
| | - Christine Brennan
- Health Policy and Systems Management Program, LSUHSC School of Public Health, New Orleans, Louisiana, United States of America
| | - Jennifer Berken
- Department of Mathematical Sciences, McNeese State University, Lake Charles, Louisiana, United States of America
| | - L. Joseph Su
- Department of Epidemiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
| | - James L. Mohler
- Department of Urology, Roswell Park Cancer Institute, Buffalo, NY, United States of America
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Jeannette T. Bensen
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Elizabeth T. H. Fontham
- Epidemiology Program, LSUHSC School of Public Health, New Orleans, Louisiana, United States of America
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17
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O'Connor AM, Sargeant JM, Dohoo IR, Erb HN, Cevallos M, Egger M, Ersbøll AK, Martin SW, Nielsen LR, Pearl DL, Pfeiffer DU, Sanchez J, Torrence ME, Vigre H, Waldner C, Ward MP. Explanation and Elaboration Document for the
STROBE
‐Vet Statement: Strengthening the Reporting of Observational Studies in Epidemiology – Veterinary Extension. Zoonoses Public Health 2016; 63:662-698. [DOI: 10.1111/zph.12315] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Indexed: 01/10/2023]
Affiliation(s)
- A. M. O'Connor
- Department of Veterinary Diagnostic and Production Animal Medicine Iowa State University Ames IA USA
| | - J. M. Sargeant
- Centre for Public Health and Zoonoses University of Guelph Guelph ON Canada
- Department of Population Medicine Ontario Veterinary College Guelph ON Canada
| | - I. R. Dohoo
- Centre for Veterinary Epidemiological Research University of Prince Edward Island Charlottetown PEI Canada
| | - H. N. Erb
- Department of Population Medicine and Diagnostic Sciences Cornell University Ithaca NY USA
| | - M. Cevallos
- Institute of Social and Preventive Medicine University of Bern BernSwitzerland
| | - M. Egger
- Institute of Social and Preventive Medicine University of Bern BernSwitzerland
| | - A. K. Ersbøll
- National Institute of Public Health University of Southern Denmark Copenhagen Denmark
| | - S. W. Martin
- Department of Population Medicine Ontario Veterinary College Guelph ON Canada
| | - L. R. Nielsen
- Section for Animal Welfare and Disease Control University of Copenhagen Copenhagen Denmark
| | - D. L. Pearl
- Department of Population Medicine Ontario Veterinary College Guelph ON Canada
| | - D. U. Pfeiffer
- Department of Production and Population Health Royal Veterinary College London UK
| | - J. Sanchez
- Department of Health Management University of Prince Edward Island Charlottetown PEI Canada
| | - M. E. Torrence
- Food and Drug Administration Center for Food Safety and Applied Nutrition College Park MD USA
| | - H. Vigre
- National Food Institute Technical University of Denmark Lyngby Denmark
| | - C. Waldner
- Department of Large Animal Clinical Sciences Western College of Veterinary Medicine University of Saskatchewan Saskatoon SK Canada
| | - M. P. Ward
- Faculty of Veterinary Science The University of Sydney Sydney NSWAustralia
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18
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O'Connor AM, Sargeant JM, Dohoo IR, Erb HN, Cevallos M, Egger M, Ersbøll AK, Martin SW, Nielsen LR, Pearl DL, Pfeiffer DU, Sanchez J, Torrence ME, Vigre H, Waldner C, Ward MP. Explanation and Elaboration Document for the STROBE-Vet Statement: Strengthening the Reporting of Observational Studies in Epidemiology-Veterinary Extension. J Vet Intern Med 2016; 30:1896-1928. [PMID: 27859752 PMCID: PMC5115190 DOI: 10.1111/jvim.14592] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 06/24/2016] [Accepted: 08/29/2016] [Indexed: 01/15/2023] Open
Abstract
The STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) statement was first published in 2007 and again in 2014. The purpose of the original STROBE was to provide guidance for authors, reviewers, and editors to improve the comprehensiveness of reporting; however, STROBE has a unique focus on observational studies. Although much of the guidance provided by the original STROBE document is directly applicable, it was deemed useful to map those statements to veterinary concepts, provide veterinary examples, and highlight unique aspects of reporting in veterinary observational studies. Here, we present the examples and explanations for the checklist items included in the STROBE-Vet statement. Thus, this is a companion document to the STROBE-Vet statement methods and process document (JVIM_14575 "Methods and Processes of Developing the Strengthening the Reporting of Observational Studies in Epidemiology-Veterinary (STROBE-Vet) Statement" undergoing proofing), which describes the checklist and how it was developed.
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Affiliation(s)
- A M O'Connor
- Department of Veterinary Diagnostic and Production Animal Medicine, Iowa State University, Ames, IA
| | - J M Sargeant
- Centre for Public Health and Zoonoses, University of Guelph, Guelph, ON, Canada.,Department of Population Medicine, Ontario Veterinary College, Guelph, ON, Canada
| | - I R Dohoo
- Centre for Veterinary Epidemiological Research, University of Prince Edward Island, Charlottetown, PEI, Canada
| | - H N Erb
- Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, NY
| | - M Cevallos
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - M Egger
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - A K Ersbøll
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - S W Martin
- Department of Population Medicine, Ontario Veterinary College, Guelph, ON, Canada
| | - L R Nielsen
- Section for Animal Welfare and Disease Control, University of Copenhagen, Copenhagen, Denmark
| | - D L Pearl
- Department of Population Medicine, Ontario Veterinary College, Guelph, ON, Canada
| | - D U Pfeiffer
- Department of Production and Population Health, Royal Veterinary College, London, UK
| | - J Sanchez
- Department of Health Management, University of Prince Edward Island, Charlottetown, PEI, Canada
| | - M E Torrence
- Food and Drug Administration, Center for Food Safety and Applied Nutrition, College Park, MD
| | - H Vigre
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - C Waldner
- Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - M P Ward
- Faculty of Veterinary Science, The University of Sydney, Sydney, Australia
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19
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Sharp L, Cotton SC, Alexander L, Williams E, Gray NM, Reid JM. Reasons for participation and non-participation in a randomized controlled trial: postal questionnaire surveys of women eligible for TOMBOLA (Trial Of Management of Borderline and Other Low-grade Abnormal smears). Clin Trials 2016; 3:431-42. [PMID: 17060217 DOI: 10.1177/1740774506070812] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Better understanding of motivators for, and barriers to, participation in randomized controlled trials (RCTs) in different study populations and settings has the potential to improve participation of historically under-represented groups (eg, women) in future trials. Purpose To investigate reasons why women agreed, or declined, to participate in a RCT. Methods In two postal questionnaire-based studies, we investigated women's reasons for participation or non-participation in TOMBOLA, a RCT comparing management policies for low-grade cervical abnormalities. Four-hundred and ninety-two TOMBOLA participants (response rate 56%) completed questionnaires on reasons for participation. One-hundred and thiry-seven women (38%) who declined TOMBOLA participation completed questionnaires on reasons for this. Results Eighty percent of women reported that one of their reasons for attending their TOMBOLA recruitment appointment was worries about their smear result. Ninety-four percent participated in the RCT because it was a worthwhile contribution to the cervical screening programme and other women; for 70% this was the most important reason. These proportions did not vary by socio-demographic factors. Thirty-two percent thought participation would result in better care. The most common reason for non-participation was preference for follow-up from the woman's GP. Logistical issues (eg, inconvenient appointments, travel time, arranging time off work or child-care) were commonly cited. Fourteen percent were too frightened to participate; this was unrelated to the grade of the recruitment smear. Limitations Response rates were not high, but there was little evidence of response bias. Structured questionnaires were used. Conclusions Future research should address how best to deliver information to ensure different social groups appreciate potential benefits of RCT participation and provide reassurance regarding fears about participation. Simple strategies (eg, appealing to the altruism of potential participants or offering flexible recruitment clinic locations and times) might enhance RCT recruitment rates. This in turn would ensure best use of research resources thus bringing the greatest benefits to participants and the population.
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Affiliation(s)
- L Sharp
- National Cancer Registry Ireland, Cork, Ireland.
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20
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Liese AD, Draper CL, Martini L, Bell BA, Freedman DA, Burke MP, Younginer N, Blake CE, Probst JC, Jones SJ. Recruitment Strategies and Participation in a Study of Childhood Hunger. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2016. [DOI: 10.1080/19320248.2015.1112760] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Angela D. Liese
- Center for Research in Nutrition and Health Disparities, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Carrie L. Draper
- Center for Research in Nutrition and Health Disparities, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Lauren Martini
- Center for Research in Nutrition and Health Disparities, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Bethany A. Bell
- Center for Research in Nutrition and Health Disparities, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Educational Psychology and Research Program, College of Education, University of South Carolina, Columbia, South Carolina, USA
| | - Darcy A. Freedman
- Center for Research in Nutrition and Health Disparities, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio, USA
| | - Michael P. Burke
- U.S. Department of Agriculture, Food and Nutrition Service, Alexandria, Virginia, USA
| | - Nicholas Younginer
- Center for Research in Nutrition and Health Disparities, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Christine E. Blake
- Center for Research in Nutrition and Health Disparities, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Janice C. Probst
- Center for Research in Nutrition and Health Disparities, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- South Carolina Rural Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Sonya J. Jones
- Center for Research in Nutrition and Health Disparities, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
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21
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Harland KK, Saftlas AF, Yankowitz J, Peek-Asa C. Risk factors for maternal injuries in a population-based sample of pregnant women. J Womens Health (Larchmt) 2015; 23:1033-8. [PMID: 25251144 DOI: 10.1089/jwh.2013.4560] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The prevalence of injuries during pregnancy is largely underestimated, as previous research has focused on more severe injuries resulting in emergency department visits and hospitalizations. The objective of our study was to estimate the frequency, risk factors, and causes of injuries in a population-based sample of pregnant women. METHODS This article is an analysis of postpartum interviews among the control series from a case-control study (n=1,488). Maternal, pregnancy, and environmental characteristics associated with injury during pregnancy in control subjects were examined to identify population-based risk factors for injury. We collected data on self-reported injury during pregnancy, including the month of pregnancy, whether medical attention was sought, the mechanism of injury, and the number and location of bodily injuries. Logistic regression was used to calculate unadjusted and adjusted odds ratios (aORs) of injury. RESULTS Over 5% of women reported an injury during pregnancy, with falls being the most common mechanism of injury. Women at highest adjusted risk for injury had unintended pregnancies (aOR: 2.28 [1.40-3.70]) and no partner during pregnancy (aOR: 2.45 [1.16-5.17]) relative to women without injuries. CONCLUSIONS Pregnant women with risk factors for many pregnancy-related complications are also at increased risk of injury during pregnancy. Further studies of pregnancy-related injuries are needed to consider environmental and maternal characteristics on risk of injury.
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Affiliation(s)
- Karisa K Harland
- 1 Injury Prevention Research Center, University of Iowa , Iowa City, Iowa
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22
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Fekete C, Segerer W, Gemperli A, Brinkhof MWG. Participation rates, response bias and response behaviours in the community survey of the Swiss Spinal Cord Injury Cohort Study (SwiSCI). BMC Med Res Methodol 2015; 15:80. [PMID: 26450702 PMCID: PMC4599658 DOI: 10.1186/s12874-015-0076-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 09/30/2015] [Indexed: 11/12/2022] Open
Abstract
Background Surveying persons with disabilities is challenging, as targeted subjects may experience specific barriers to survey participation. Here we report on participation rates and response behaviour in a community survey of people with spinal cord injury (SCI) in Switzerland. The cross-sectional survey was implemented as part of the Swiss Spinal Cord Injury Cohort Study (SwiSCI) and represents the largest population-based SCI survey in Europe including nearly 2000 persons. Design features to enhance participation rates included the division of the questionnaire volume over three successive modules; recurrent and mixed-mode reminding of non-responders; and mixed-mode options for response. Methods We describe participation rates of the SwiSCI community survey (absolute and cumulative cooperation, contact, response, and attrition rates) and report on response rates in relation to recruitment efforts. Potential non-response bias and the association between responders’ characteristics and response behaviour (response speed: reminding until participation; response mode: paper-pencil vs. online completion) were assessed using regression modelling. Results Over the successive modules, absolute response rates were 61.1, 80.6 and 87.3 % which resulted in cumulative response rates of 49.3 and 42.6 % for the second and third modules. Written reminders effectively increased response rates, with the first reminder showing the largest impact. Telephone reminders, partly with direct telephone interviewing, enhanced response rate to the first module, but were essentially redundant in subsequent modules. Non-response to the main module was related to current age, membership of Swiss Paraplegic Association (SPA) and time since injury, but not to gender, lesion level and preferred language of response. Response speed increased with household income, but was not associated to other sociodemographic factors, lesion characteristics or health indicators. We found significant associations between online completion and male gender, younger age, higher education, higher income, SPA membership, tetraplegia, longer time since injury, higher quality of life, and more participation restrictions. Conclusion In this sample with little non-response bias, recurrent and mixed-mode reminding and mixed-mode options for response were key features of optimizing survey design.
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Affiliation(s)
- Christine Fekete
- Swiss Paraplegic Research, Guido A. Zäch Strasse 4, 6207, Nottwil, Switzerland.
| | - Wolfgang Segerer
- Swiss Paraplegic Research, Guido A. Zäch Strasse 4, 6207, Nottwil, Switzerland.
| | - Armin Gemperli
- Swiss Paraplegic Research, Guido A. Zäch Strasse 4, 6207, Nottwil, Switzerland. .,Department of Health Sciences and Health Policy, University of Lucerne, Frohburgstrasse 3, P.O. Box 4466, 6002, Lucerne, Switzerland.
| | - Martin W G Brinkhof
- Swiss Paraplegic Research, Guido A. Zäch Strasse 4, 6207, Nottwil, Switzerland. .,Department of Health Sciences and Health Policy, University of Lucerne, Frohburgstrasse 3, P.O. Box 4466, 6002, Lucerne, Switzerland.
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23
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Castaño-Vinyals G, Aragonés N, Pérez-Gómez B, Martín V, Llorca J, Moreno V, Altzibar JM, Ardanaz E, de Sanjosé S, Jiménez-Moleón JJ, Tardón A, Alguacil J, Peiró R, Marcos-Gragera R, Navarro C, Pollán M, Kogevinas M. Population-based multicase-control study in common tumors in Spain (MCC-Spain): rationale and study design. GACETA SANITARIA 2015; 29:308-15. [PMID: 25613680 DOI: 10.1016/j.gaceta.2014.12.003] [Citation(s) in RCA: 144] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 12/11/2014] [Accepted: 12/12/2014] [Indexed: 12/28/2022]
Abstract
INTRODUCTION We present the protocol of a large population-based case-control study of 5 common tumors in Spain (MCC-Spain) that evaluates environmental exposures and genetic factors. METHODS Between 2008-2013, 10,106 subjects aged 20-85 were enrolled in 23 hospitals and primary care centres in 12 Spanish provinces including 1,112 cases with a new diagnosis of prostate cancer, 1,738 of breast cancer, 2,140 of colorectal cancer, 459 of gastro-oesophageal cancer, 559 cases with chronic lymphocytic leukaemia and 4,098 population controls frequency matched to cases by age, sex and region of residence. Participation rates ranged from 57% (stomach cancer) to 87% (CLL cases) and from 30% to 77% in controls. Participants completed a face-to-face computerized interview on sociodemographic factors, environmental exposures, occupation, medication, lifestyle, and personal and family medical history. In addition, participants completed a self-administered food-frequency questionnaire and telephone interviews. Blood samples were collected from 76% of participants while saliva samples were collected in CLL cases and participants refusing blood extractions. Clinical information was recorded for cases and paraffin blocks and/or fresh tumor samples are available in most collaborating hospitals. Genotyping was done through an exome array enriched with genetic markers in specific pathways. Multiple analyses are planned to assess the association of environmental, personal and genetic risk factors for each tumor and to identify pleiotropic effects. DISCUSSION This study, conducted within the Spanish Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), is a unique initiative to evaluate etiological factors for common cancers and will promote cancer research and prevention in Spain.
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Affiliation(s)
- Gemma Castaño-Vinyals
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | - Nuria Aragonés
- Environmental and Cancer Epidemiology Unit, National Center of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; IIS Puerta de Hierro, Majadahonda, Spain
| | - Beatriz Pérez-Gómez
- Environmental and Cancer Epidemiology Unit, National Center of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; IIS Puerta de Hierro, Majadahonda, Spain
| | - Vicente Martín
- Universidad de León, León, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Javier Llorca
- Universidad de Cantabria, Santander, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Victor Moreno
- IDIBELL-Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain; Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Jone M Altzibar
- Subdirección de Salud Pública de Gipuzkoa, Donostia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Eva Ardanaz
- Instituto de Salud Pública de Navarra, Pamplona, Navarra; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Sílvia de Sanjosé
- IDIBELL-Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - José Juan Jiménez-Moleón
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Adonina Tardón
- Instituto Universitario de Oncología, Universidad de Oviedo, Oviedo, Asturias, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Juan Alguacil
- Centro de Investigación en Salud y Medio Ambiente (CYSMA), Universidad de Huelva, Huelva, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Rosana Peiró
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana FISABIO-Salud Pública, Valencia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Rafael Marcos-Gragera
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Girona Biomedical Research Institute (IdiBGi), Girona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Carmen Navarro
- Department of Epidemiology, Murcia Regional Health Authority, Murcia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain
| | - Marina Pollán
- Environmental and Cancer Epidemiology Unit, National Center of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; IIS Puerta de Hierro, Majadahonda, Spain
| | - Manolis Kogevinas
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; School of Public Health, Athens, Greece
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Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. Int J Surg 2014; 12:1500-24. [PMID: 25046751 DOI: 10.1016/j.ijsu.2014.07.014] [Citation(s) in RCA: 1527] [Impact Index Per Article: 152.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Much medical research is observational. The reporting of observational studies is often of insufficient quality. Poor reporting hampers the assessment of the strengths and weaknesses of a study and the generalisability of its results. Taking into account empirical evidence and theoretical considerations, a group of methodologists, researchers, and editors developed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations to improve the quality of reporting of observational studies. The STROBE Statement consists of a checklist of 22 items, which relate to the title, abstract, introduction, methods, results and discussion sections of articles. Eighteen items are common to cohort studies, case-control studies and cross-sectional studies and four are specific to each of the three study designs. The STROBE Statement provides guidance to authors about how to improve the reporting of observational studies and facilitates critical appraisal and interpretation of studies by reviewers, journal editors and readers. This explanatory and elaboration document is intended to enhance the use, understanding, and dissemination of the STROBE Statement. The meaning and rationale for each checklist item are presented. For each item, one or several published examples and, where possible, references to relevant empirical studies and methodological literature are provided. Examples of useful flow diagrams are also included. The STROBE Statement, this document, and the associated Web site (http://www.strobe-statement.org/) should be helpful resources to improve reporting of observational research.
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Zinkhan M, Stang A, Jöckel KH, Marr A, Bornfeld N, Schmidt-Pokrzywniak A. Having children, social characteristics, smoking and the risk of uveal melanoma: a case-control study. Ophthalmic Epidemiol 2014; 20:360-8. [PMID: 24229069 DOI: 10.3109/09286586.2013.844842] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE We analyzed data from the Risk Factors for Uveal Melanoma (RIFA) study to evaluate possible associations between uveal melanoma risk and having children, socioeconomic level and smoking. METHODS The RIFA study was a German case-control study conducted from September 2002 to March 2005. The study population consisted of 455 incident uveal melanoma patients (20-74 years of age) and 827 matched (age, sex, region of residence) population controls. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using conditional logistic regression. RESULTS Women with children showed an increased OR (1.59, 95% CI 0.95-2.66) for uveal melanoma development compared to women without children. We estimated decreased ORs for subjects with higher socioeconomic level compared to the lowest status (upper secondary school leaving certificate: OR 0.68, 95% CI 0.49-0.94; higher education: OR 0.60, 95% CI 0.38-0.96). Ever smokers showed an OR of 1.19 (95% CI 0.92-1.55) compared to never smokers. CONCLUSION The observed association between lower socioeconomic level and increased odds for uveal melanoma possibly represents a higher occupational uveal melanoma risk for occupational categories that are usually associated with lower socioeconomic status. Concerning having children and uveal melanoma development, we hypothesize that the observed association is mediated through alpha-melanocyte-stimulating hormone, a hormone that increases during pregnancy and is linked to pigmentation alterations in pregnant women.
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Affiliation(s)
- Melanie Zinkhan
- Institute of Clinical Epidemiology, Medical Faculty, Martin-Luther-University of Halle-Wittenberg , Halle , Germany
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Clagett B, Nathanson KL, Ciosek SL, McDermoth M, Vaughn DJ, Mitra N, Weiss A, Martonik R, Kanetsky PA. Comparison of address-based sampling and random-digit dialing methods for recruiting young men as controls in a case-control study of testicular cancer susceptibility. Am J Epidemiol 2013; 178:1638-47. [PMID: 24008901 DOI: 10.1093/aje/kwt164] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Random-digit dialing (RDD) using landline telephone numbers is the historical gold standard for control recruitment in population-based epidemiologic research. However, increasing cell-phone usage and diminishing response rates suggest that the effectiveness of RDD in recruiting a random sample of the general population, particularly for younger target populations, is decreasing. In this study, we compared landline RDD with alternative methods of control recruitment, including RDD using cell-phone numbers and address-based sampling (ABS), to recruit primarily white men aged 18-55 years into a study of testicular cancer susceptibility conducted in the Philadelphia, Pennsylvania, metropolitan area between 2009 and 2012. With few exceptions, eligible and enrolled controls recruited by means of RDD and ABS were similar with regard to characteristics for which data were collected on the screening survey. While we find ABS to be a comparably effective method of recruiting young males compared with landline RDD, we acknowledge the potential impact that selection bias may have had on our results because of poor overall response rates, which ranged from 11.4% for landline RDD to 1.7% for ABS.
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Saftlas AF, Rubenstein L, Prater K, Harland KK, Field E, Triche EW. Cumulative exposure to paternal seminal fluid prior to conception and subsequent risk of preeclampsia. J Reprod Immunol 2013; 101-102:104-110. [PMID: 24011785 DOI: 10.1016/j.jri.2013.07.006] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Revised: 06/24/2013] [Accepted: 07/02/2013] [Indexed: 12/15/2022]
Abstract
A growing body of literature suggests that prior and prolonged exposure to paternal antigens in seminal fluid induces maternal tolerance to the allogeneic fetus, protecting it from rejection and facilitating successful implantation and placentation. In this case-control study of nulliparous women, we test the hypothesis that increased exposure to paternal seminal fluid via the vaginal or oral route will confer a reduced risk of preeclampsia. Preeclampsia cases (n=258) and normotensive controls (n=182) were selected from live births to Iowa women over the period August 2002 to April 2005. Disease status was verified by medical chart review. Seminal fluid exposure indexes incorporated information on type and frequency of sexual practices, contraceptive use, and ingestion practices prior to conception with the baby's father. Preeclampsia risk decreased significantly with increasing vaginal exposure to paternal semen (test for trend p<0.05). Women in the highest 10th percentile of vaginal exposure had a 70% reduced odds of preeclampsia relative to women in the lowest 25th percentile of exposure (aOR=0.3; 95% CI: 0.1-0.9). Oral seminal fluid exposure was not associated with a reduced risk of preeclampsia. These findings are congruent with the immune maladaptation hypothesis of preeclampsia causation and indicate that paternal antigen exposure via the vaginal mucosa may facilitate immune tolerance to paternal HLA. Thus, advising nulliparous women to decrease their use of barrier contraceptive methods and to increase vaginal sexual intercourse prior to conceiving may reduce their risk of preeclampsia.
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Affiliation(s)
- Audrey F Saftlas
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA 52242, USA
| | - Linda Rubenstein
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA 52242, USA
| | - Kaitlin Prater
- Department of Epidemiology, Department of Health Management and Policy, University of Iowa College of Public Health, Iowa City, IA 52242, USA
| | - Karisa K Harland
- Department of Occupational and Environmental Health, University of Iowa College of Public Health, Iowa City, IA 52242, USA
| | - Elizabeth Field
- Veterans Administration Medical Center, Iowa City, IA 52246, USA; Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, The University of Iowa, Iowa City, IA 52242, USA
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Risk of adult acute and chronic myeloid leukemia with cigarette smoking and cessation. Cancer Epidemiol 2013; 37:410-6. [PMID: 23643192 DOI: 10.1016/j.canep.2013.03.012] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Revised: 03/25/2013] [Accepted: 03/26/2013] [Indexed: 12/20/2022]
Abstract
BACKGROUND Cigarette smoking is an established risk factor for adult myeloid leukemia, particularly acute myeloid leukemia (AML), but less is known about the nature of this association and effects of smoking cessation on risk. METHODS In a large population-based case-control study of myeloid leukemia that included 414 AML and 185 chronic myeloid leukemia (CML) cases and 692 controls ages 20-79 years, we evaluated risk associated with cigarette smoking and smoking cessation using unconditional logistic regression methods and cubic spline modeling. RESULTS AML and CML risk increased with increasing cigarette smoking intensity in men and women. A monotonic decrease in AML risk was observed with increasing time since quitting, whereas for CML, the risk reduction was more gradual. For both AML and CML, among long-term quitters (≥30 years), risk was comparable to non-smokers. CONCLUSIONS Our study confirms the increased risk of myeloid leukemia with cigarette smoking and provides encouraging evidence of risk attenuation following cessation.
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Liu AY, Scherer D, Poole E, Potter JD, Curtin K, Makar K, Slattery ML, Caan BJ, Ulrich CM. Gene-diet-interactions in folate-mediated one-carbon metabolism modify colon cancer risk. Mol Nutr Food Res 2012; 57:721-34. [PMID: 22961839 DOI: 10.1002/mnfr.201200180] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2012] [Revised: 05/15/2012] [Accepted: 05/31/2012] [Indexed: 12/21/2022]
Abstract
SCOPE The importance of folate-mediated one-carbon metabolism (FOCM) in colorectal carcinogenesis is emphasized by observations that high dietary folate intake is associated with decreased risk of colon cancer (CC) and its precursors. Additionally, polymorphisms in FOCM-related genes have been repeatedly associated with risk, supporting a causal relationship between folate and colorectal carcinogenesis. METHODS AND RESULTS We investigated ten candidate polymorphisms with defined or probable functional impact in eight FOCM-related genes (SHMT1, DHFR, DNMT1, MTHFD1, MTHFR, MTRR, TCN2, and TDG) in 1609 CC cases and 1974 controls for association with CC risk and for interaction with dietary factors. No polymorphism was statistically significantly associated with overall risk of CC. However, statistically significant interactions modifying CC risk were observed for DNMT1 I311V with dietary folate, methionine, vitamin B2 , and vitamin B12 intake and for MTRR I22M with dietary folate, a predefined one-carbon dietary pattern, and vitamin B6 intake. We observed statistically significant gene-diet interactions with five additional polymorphisms. CONCLUSION Our results provide evidence that FOCM-related dietary intakes modify the association between CC risk and FOCM allelic variants. These findings add to observations showing that folate-related gene-nutrient interactions play an important role in modifying the risk of CC.
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Affiliation(s)
- Amy Y Liu
- Department of Epidemiology, University of Washington, Seattle, WA, USA
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Harland KK, Saftlas AF, Wallis AB, Yankowitz J, Triche EW, Zimmerman MB. Correction of systematic bias in ultrasound dating in studies of small-for-gestational-age birth: an example from the Iowa Health in Pregnancy Study. Am J Epidemiol 2012; 176:443-55. [PMID: 22886591 DOI: 10.1093/aje/kws120] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The authors examined whether early ultrasound dating (≤20 weeks) of gestational age (GA) in small-for-gestational-age (SGA) fetuses may underestimate gestational duration and therefore the incidence of SGA birth. Within a population-based case-control study (May 2002-June 2005) of Iowa SGA births and preterm deliveries identified from birth records (n = 2,709), the authors illustrate a novel methodological approach with which to assess and correct for systematic underestimation of GA by early ultrasound in women with suspected SGA fetuses. After restricting the analysis to subjects with first-trimester prenatal care, a nonmissing date of the last menstrual period (LMP), and early ultrasound (n = 1,135), SGA subjects' ultrasound GA was 5.5 days less than their LMP GA, on average. Multivariable linear regression was conducted to determine the extent to which ultrasound GA predicted LMP dating and to correct for systematic misclassification that results after applying standard guidelines to adjudicate differences in these measures. In the unadjusted model, SGA subjects required a correction of +1.5 weeks to the ultrasound estimate. With adjustment for maternal age, smoking, and first-trimester vaginal bleeding, standard guidelines for adjudicating differences in ultrasound and LMP dating underestimated SGA birth by 12.9% and overestimated preterm delivery by 8.7%. This methodological approach can be applied by researchers using different study populations in similar research contexts.
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Affiliation(s)
- Karisa K Harland
- Injury Prevention Research Center and Department of Epidemiology, University of Iowa, Iowa City, IA 52242-5000, USA.
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Johnson KJ, Blair CM, Fink JM, Cerhan JR, Roesler MA, Hirsch BA, Nguyen PL, Ross JA. Medical conditions and risk of adult myeloid leukemia. Cancer Causes Control 2012; 23:1083-9. [PMID: 22576581 DOI: 10.1007/s10552-012-9977-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2012] [Accepted: 04/16/2012] [Indexed: 12/12/2022]
Abstract
PURPOSE Although a few previous studies have reported positive associations between adult myeloid leukemia and a history of certain medical conditions, the etiology of most cases remains largely unknown. Our purpose was to examine associations between certain medical conditions and adult myeloid leukemia. METHODS Using logistic regression, we evaluated associations between 16 self-reported medical conditions and myeloid leukemia in a case-control study of 670 cases [including 420 acute myeloid leukemia (AML) and 186 chronic myelogenous leukemia (CML)] and 701 population-based controls. RESULTS We observed significant positive associations between AML and ulcerative colitis (odds ratio (OR) = 3.8; 95 % confidence interval (CI), 1.1-13) and between CML and peptic ulcer (OR = 2.0; 95% CI, 1.1-3.8). A personal cancer history increased both AML (OR = 2.6; 95% CI, 1.7-3.9) and CML (OR = 3.5; 95% CI, 2.0-5.8) risk even after excluding individuals who reported prior radiation and/or chemotherapy treatment. CONCLUSION Certain inflammatory medical conditions and a personal history of cancer, independent from therapy, are associated with an increased risk of myeloid leukemia.
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Linabery AM, Slater ME, Spector LG, Olshan AF, Stork SK, Roesler MA, Reaman GH, Ross JA. Feasibility of neonatal dried blood spot retrieval amid evolving state policies (2009-2010): a Children's Oncology Group study. Paediatr Perinat Epidemiol 2011; 25:549-58. [PMID: 21980944 PMCID: PMC3664237 DOI: 10.1111/j.1365-3016.2011.01228.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Dried blood spots (DBS) are collected uniformly from US newborns to test for metabolic and other disorders. Because evidence exists for prenatal origins of some diseases, DBS may provide unique prenatal exposure records. Some states retain residual DBS and permit their use in aetiological studies. The primary study aim was to assess the feasibility of obtaining residual DBS from state newborn screening programmes for paediatric and adolescent cancer patients nationwide with parental/subject consent/assent. Families of leukaemia and lymphoma patients aged ≤21 years diagnosed from 1998 to 2007 at randomly selected Children's Oncology Group institutions across the US were questioned (n = 947). Parents/guardians and patients aged ≥18 years were asked to release DBS to investigators in spring 2009. DBS were then requested from states. Overall, 299 families (32%) released DBS. Consenting/assenting patients were born in 39 US states and 46 DBS were obtained from five states; 124 DBS were unobtainable because patients were born prior to dates of state retention. State policies are rapidly evolving and there is ongoing discussion regarding DBS storage and secondary research uses. Currently, population-based DBS studies can be conducted in a limited number of states; fortunately, many have large populations to provide reasonably sized paediatric subject groups.
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Affiliation(s)
- Amy M. Linabery
- Division of Pediatric Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Megan E. Slater
- Division of Pediatric Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Logan G. Spector
- Division of Pediatric Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota,University of Minnesota Masonic Cancer Center, Minneapolis, Minnesota
| | - Andrew F. Olshan
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina
| | - Susan K. Stork
- Pediatric Hematology/Oncology, Raymond Blank Children’s Hospital, Des Moines, Iowa
| | - Michelle A. Roesler
- Division of Pediatric Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Gregory H. Reaman
- Department of Hematology-Oncology, Children’s National Medical Center, Washington, District of Columbia
| | - Julie A. Ross
- Division of Pediatric Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota,University of Minnesota Masonic Cancer Center, Minneapolis, Minnesota
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Castaño-Vinyals G, Nieuwenhuijsen MJ, Moreno V, Carrasco E, Guinó E, Kogevinas M, Villanueva CM. Participation rates in the selection of population controls in a case-control study of colorectal cancer using two recruitment methods. GACETA SANITARIA 2011; 25:353-6. [DOI: 10.1016/j.gaceta.2010.05.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2010] [Revised: 05/06/2010] [Accepted: 05/07/2010] [Indexed: 10/18/2022]
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Ross JA, Blair CK, Cerhan JR, Soler JT, Hirsch BA, Roesler MA, Higgins RR, Nguyen PL. Nonsteroidal anti-inflammatory drug and acetaminophen use and risk of adult myeloid leukemia. Cancer Epidemiol Biomarkers Prev 2011; 20:1741-50. [PMID: 21715605 DOI: 10.1158/1055-9965.epi-11-0411] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Little is known about the causes of adult leukemia. A few small studies have reported a reduced risk associated with regular use of nonsteroidal anti-inflammatory drugs (NSAID). METHODS In a population-based case-control study, we evaluated analgesic use among 670 newly diagnosed myeloid leukemia cases [including 420 acute myeloid leukemias (AML) and 186 chronic myeloid leukemias (CML)] and 701 controls aged 20 to 79 years. Prior use of aspirin, ibuprofen, acetaminophen, other NSAIDs, and COX-2 inhibitors was assessed and included frequency, duration, and quantity. ORs and 95% CIs were calculated using unconditional logistic regression adjusting for potential confounders. RESULTS Regular/extra strength aspirin use was inversely associated with myeloid leukemia in women (OR = 0.59, 95% CI = 0.37-0.93) but not in men (OR = 0.85, 95% CI = 0.58-1.24). In contrast, acetaminophen use was associated with an increased risk of myeloid leukemia in women only (OR = 1.60, 95% CI = 1.04-2.47). These relationships were stronger with increasing dose and duration. When stratified by leukemia type, aspirin use was inversely associated with AML and CML in women. No significant overall associations were found with ibuprofen or COX-2 inhibitors for either sex; however, a decreased risk was observed with other anti-inflammatory analgesic use for women with AML or CML (OR = 0.47, 95% CI = 0.22-0.99; OR = 0.31, 95% CI = 0.10-0.92, respectively). CONCLUSIONS Our results provide additional support for the chemopreventive benefits of NSAIDs, at least in women. Because leukemia ranks fifth in person-years of life lost due to malignancy, further investigation is warranted. IMPACT NSAIDs may reduce, whereas acetaminophen may increase, myeloid leukemia risk in women.
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Affiliation(s)
- Julie A Ross
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN 55455, USA.
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Knoll L, Felten MK, Ackermann D, Kraus T. Non-response bias in a surveillance program for asbestos-related lung cancer. J Occup Health 2010; 53:16-22. [PMID: 21079373 DOI: 10.1539/joh.l10061] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES In a cohort study non-response might lead to a biased selection of cohort members and may affect the validity and reliability of the study outcome. To detect the possible effects of a non-response bias on study results, we evaluated the reasons for non-participation and the differences of respondents and non-respondents in a health surveillance program for power industry workers, formerly exposed to asbestos. METHODS A cohort of former power plant workers was formed to participate in an early detection program for lung cancer. We evaluated the results of 1,019 individuals (mean age 66 yr), of which 839 took part in at least one examination, 180 refused to participate or did not respond. To obtain the reasons for non-response, we interviewed the cohort members by telephone or we requested them by mail to complete and return a brief questionnaire. Further sources of information were the communal registration offices and local health offices. RESULTS The main reasons for non-participation were refusal (35%), illness (23.3%), death (16.7%) and difficulties with traveling (13.3%). It was impossible to make contact with or obtain an explanation from 11.7%. In a logistic regression model we demonstrated that advanced age and a long travel distance from the study center negatively affected the participation rate (p<0.001). There was no difference between respondents and non-respondents regarding prevalence (p=0.559) and incidence of lung cancer (p=0.882). CONCLUSION We concluded that in our cohort non-participation did not cause a selection bias in terms of lung cancer rates.
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Affiliation(s)
- Lars Knoll
- Institute of Occupational Medicine, RWTH Aachen University, Germany.
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Schmidt-Pokrzywniak A, Jöckel KH, Marr A, Bornfeld N, Stang A. A case-control study: occupational cooking and the risk of uveal melanoma. BMC Ophthalmol 2010; 10:26. [PMID: 20969762 PMCID: PMC2978138 DOI: 10.1186/1471-2415-10-26] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2010] [Accepted: 10/22/2010] [Indexed: 12/01/2022] Open
Abstract
Background A European-wide population based case-control study (European rare cancer study) undertaken in nine European countries examined risk factors for uveal melanoma. They found a positive association between cooks and the risk of uveal melanoma. In our study we examine whether cooks or people who worked in cook related jobs have an increased uveal melanoma risk. Methods We conducted a case-control study during 2002 and 2005. Overall, 1653 eligible subjects (age range: 20-74 years, living in Germany) participated. Interviews were conducted with 459 incident uveal melanoma cases, 827 population controls, 180 ophthalmologist controls and 187 sibling controls. Data on occupational exposure were obtained from a self-administered postal questionnaire and a computer-assisted telephone interview. We used conditional logistic regression to estimate odds ratios adjusting for the matching factors. Results Overall, we did not observe an increased risk of uveal melanoma among people who worked as cooks or who worked in cook related jobs. When we restricted the source population of our study to the population of the Federal State of Northrhine-Westphalia, we observed an increased risk among subjects who were categorized as cooks in the cases-control analysis. Conclusion Our results are in conflict with former results of the European rare cancer study. Considering the rarity of the disease laboratory in vitro studies of human uveal melanoma cell lines should be done to analyze potential exposure risk factors like radiation from microwaves, strong light from incandescent ovens, or infrared radiation.
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Harris MA. Invited commentary: Evaluating epidemiologic research methods--the importance of response rate calculation. Am J Epidemiol 2010; 172:645-7; discussion 651-2. [PMID: 20660120 DOI: 10.1093/aje/kwq219] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Epidemiologic research that uses administrative records (rather than registries or clinical surveys) to identify cases for study has been increasingly restricted because of concerns about privacy, making unbiased population-based research less practicable. In their article, Nattinger et al. (Am J Epidemiol. 2010;172(6):637-644) present a method for using administrative data to contact participants that has been well received. However, the methods employed for calculating and reporting response rates require further consideration, particularly the classification of untraceable cases as ineligible. Depending on whether response rates are used to evaluate the potential for bias to influence study results or to evaluate the acceptability of the method of contact, different fractions may be considered. To improve the future study of epidemiologic research methods, a consensus on the calculation and reporting of study response rates should be sought.
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Affiliation(s)
- M Anne Harris
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
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Johnson KJ, Roesler MA, Linabery AM, Hilden JM, Davies SM, Ross JA. Infant leukemia and congenital abnormalities: a Children's Oncology Group study. Pediatr Blood Cancer 2010; 55:95-9. [PMID: 20486175 PMCID: PMC2904947 DOI: 10.1002/pbc.22495] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Leukemia in infants is rare and has not been well studied apart from leukemia in older children. Differences in survival and the molecular characteristics of leukemia in infants versus older children suggest a distinct etiology, likely involving prenatal factors. PROCEDURE We examined the association between eight categories of maternally reported congenital abnormalities (CAs) (cleft lip or palate, spina bifida or other spinal defect, large or multiple birthmarks, other chromosomal abnormalities, small head or microcephaly, rib abnormalities, urogenital abnormalities, and other) and infant leukemia in a case-control study. The study included 443 cases diagnosed at <1 year of age at a Children's Oncology Group Institution in the United States or Canada from 1996 to 2006 and 324 controls. Controls were recruited from the cases' geographic area either by random digit dialing (1999-2002) or through birth certificates (2003-2008) and were frequency-matched to cases on birth year. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by unconditional logistic regression after adjustment for birth year and a measure of follow-up time to account for differences in the CA observation period. RESULTS No statistically significant associations were observed between infant leukemia and any CA (OR = 1.2; 95% CI: 0.8-1.9), birthmarks (OR = 1.4; 95% CI: 0.7-2.5), urogenital abnormalities (OR = 0.7; 95% CI: 0.2-2.0), or other CA (OR = 1.4; 95% CI: 0.7-2.8). Results were similar for acute lymphoblastic and myeloid leukemia cases. Fewer than five subjects were in the remaining CA categories precluding analysis. CONCLUSIONS Overall, we did not find evidence to support an association between CAs and infant leukemia.
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Affiliation(s)
- Kimberly J. Johnson
- Department of Pediatrics, Division of Epidemiology/Clinical Research, University of Minnesota, Minneapolis, MN
| | - Michelle A. Roesler
- Department of Pediatrics, Division of Epidemiology/Clinical Research, University of Minnesota, Minneapolis, MN
| | - Amy M. Linabery
- Department of Pediatrics, Division of Epidemiology/Clinical Research, University of Minnesota, Minneapolis, MN
| | - Joanne M. Hilden
- Department of Pediatric Hematology/Oncology, Peyton Manning Children’s Hospital at St. Vincent, Indianapolis, IN
| | | | - Julie A. Ross
- Department of Pediatrics, Division of Epidemiology/Clinical Research, University of Minnesota, Minneapolis, MN
,Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455
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Saftlas AF, Wallis AB, Shochet T, Harland KK, Dickey P, Peek-Asa C. Prevalence of intimate partner violence among an abortion clinic population. Am J Public Health 2010; 100:1412-5. [PMID: 20558796 DOI: 10.2105/ajph.2009.178947] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
In this cross-sectional, clinic-based study, we estimated 1-year prevalence of intimate partner violence among 986 patients who had elective abortions. We assessed physical, sexual, and battering intimate partner violence via self-administered, computer-based questionnaires. Overall, physical and sexual intimate partner violence prevalence was 9.9% and 2.5%, respectively; 8.4% of those in a current relationship reported battering. Former partners perpetrated more physical and sexual assaults than did current partners. Violence severity increased with frequency. Abortion patients experience high intimate partner violence rates, indicating the need for targeted screening and community-based referral.
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Affiliation(s)
- Audrey F Saftlas
- Department of Epidemiology, University of Iowa, Iowa City, 52242, USA.
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Puumala SE, Spector LG, Wall MM, Robison LL, Heerema NA, Roesler MA, Ross JA. Infant leukemia and parental infertility or its treatment: a Children's Oncology Group report. Hum Reprod 2010; 25:1561-8. [PMID: 20382971 DOI: 10.1093/humrep/deq090] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Little is known about the potential risk factors for infant leukemia. With its very young age at diagnosis, exposures occurring in the perinatal period are suspected. Parental infertility and infertility treatment have been studied with regard to childhood cancer in general, but rarely in individual cancer subtypes. METHODS A case-control study of infant leukemia was conducted through the Children's Oncology Group, including cases diagnosed from January 1996 to December 2006 and controls selected through random digit dialing and birth certificate tracing. Maternal phone interviews were conducted to obtain information about infertility, infertility treatment and demographic factors. All cases as well as subgroups defined by mixed lineage leukemia (MLL) translocation status and leukemia subtype were examined. Statistical analysis was performed using multivariate logistic regression models. RESULTS No significant associations between infertility or its treatment and combined infant leukemia were found. In subgroup analyses, there was a significant increase in the risk of MLL--leukemia for children born to women not trying to conceive compared with those trying for <1 year for all types combined [odds ratio (OR) = 1.62, 95% confidence interval (CI) = 1.01-2.59] and for acute lymphoblastic leukemia (OR = 2.50, 95% CI = 1.36-4.61). CONCLUSIONS There were no positive associations between parental infertility or infertility treatment and infant leukemia. While this is the largest study to date, both selection and recall bias may have impacted the results. However, for infant leukemia, we can potentially rule out large increases in risk associated with parental infertility or its treatment.
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Affiliation(s)
- Susan E Puumala
- Division of Epidemiology/Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN 55455, USA
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Puumala SE, Spector LG, Robison LL, Bunin GR, Olshan AF, Linabery AM, Roesler MA, Blair CK, Ross JA. Comparability and representativeness of control groups in a case-control study of infant leukemia: a report from the Children's Oncology Group. Am J Epidemiol 2009; 170:379-87. [PMID: 19498073 DOI: 10.1093/aje/kwp127] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Traditionally, controls in US pediatric cancer studies were selected through random digit dialing. With declining participation and lack of nonparticipant information, random digit dialing (RDD) controls may be substandard. Birth certificate (BC) controls are an alternative, because they are population based and include data from nonparticipants. The authors examined controls collected by random digit dialing and birth certificates for a Children's Oncology Group case-control study of infant leukemia in 1995-2006. Demographic variables were used to assess differences in RDD and BC controls and their representativeness. RDD and BC controls did not differ significantly with regard to maternal variables (age, race, education, marital status, alcohol during pregnancy) or child variables (sex, gestational age, birth weight), but they varied in smoking during pregnancy (22% RDD controls, 12% BC controls) (P = 0.05). The study's combined control group differed significantly from US births: Mothers of controls were more likely to be older (29.8 vs. 27.2 years), white (84% vs. 59%), and married (85% vs. 67%) and to have >16 years of education (37% vs. 25%). Control children were more often full term (88% vs. 81%) and heavier (3,436 vs. 3,317 g). Finally, participating BC mothers were likely to be older and to have more education than nonparticipants. Thus, the study's control groups were comparable but differed from the population of interest.
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Affiliation(s)
- Susan E Puumala
- Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN 55455, USA
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Satia JA, Tseng M, Galanko JA, Martin C, Sandler RS. Dietary patterns and colon cancer risk in Whites and African Americans in the North Carolina Colon Cancer Study. Nutr Cancer 2009; 61:179-93. [PMID: 19235034 DOI: 10.1080/01635580802419806] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
We examined associations of dietary patterns with colon cancer risk in African Americans and Whites from a case-control study in North Carolina. Incident colon cancer cases, 40 to 80 yr (n = 636), and matched controls (n = 1,042) were interviewed in person to elicit information on potential colon cancer risk factors. A validated food frequency questionnaire adapted to include regional foods captured diet over the year prior to diagnosis (cases) or interview date (controls). Three meaningful intake patterns were identified in both Whites and African Americans: "Western-Southern," "fruit-vegetable," and "metropolitan." Compared to the Western-Southern pattern, the fruit-vegetable and metropolitan patterns were associated with more healthful dietary behaviors (e.g., higher vegetable intake and lower red meat consumption), and demographic/lifestyle characteristics typically correlated with low colon cancer risk, for example, lower BMI, higher education, and higher NSAID use. The fruit-vegetable pattern was significantly inversely associated with colon cancer risk in Whites (OR = 0.4, 95% CI = 0.3-0.6) and the metropolitan pattern with a nonsignificant 30% risk reduction in both Whites and African Americans after adjustment for education. The Western-Southern pattern was not associated with colon cancer risk. These findings may explain some of the racial differences in colon cancer incidence and underscore the importance of examining diet-cancer associations in different population subgroups.
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Affiliation(s)
- Jessie A Satia
- Department of Nutrition, Schools of Public Health and Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
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Vandenbroucke JP, Von Elm E, Altman DG, Gøtzsche PC, Mulrow CD, Pocock SJ, Poole C, Schlesselman JJ, Egger M. [Strengthening the reporting of observational studies in epidemiology (STROBE): explanation and elaboration]. GACETA SANITARIA 2009; 23:158. [PMID: 19249134 DOI: 10.1016/j.gaceta.2008.12.001] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Much medical research is observational. The reporting of observational studies is often of insufficient quality. Poor reporting hampers the assessment of the strengths and weaknesses of a study and the generalisability of its results. Taking into account empirical evidence and theoretical considerations, a group of methodologists, researchers, and editors developed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations to improve the quality of reporting of observational studies. The STROBE Statement consists of a checklist of 22 items, which relate to the title, abstract, introduction, methods, results and discussion sections of articles. Eighteen items are common to cohort studies, case-control studies and cross-sectional studies and four are specific to each of the three study designs. The STROBE Statement provides guidance to authors about how to improve the reporting of observational studies and facilitates critical appraisal and interpretation of studies by reviewers, journal editors and readers. This explanatory and elaboration document is intended to enhance the use, understanding, and dissemination of the STROBE Statement. The meaning and rationale for each checklist item are presented. For each item, one or several published examples and, where possible, references to relevant empirical studies and methodological literature are provided. Examples of useful flow diagrams are also included. The STROBE Statement, this document, and the associated Web site (http://www.strobe-statement.org/) should be helpful resources to improve reporting of observational research.
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Affiliation(s)
- Jan P Vandenbroucke
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
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Vrijheid M, Richardson L, Armstrong BK, Auvinen A, Berg G, Carroll M, Chetrit A, Deltour I, Feychting M, Giles GG, Hours M, Iavarone I, Lagorio S, Lönn S, Mcbride M, Parent ME, Sadetzki S, Salminen T, Sanchez M, Schlehofer B, Schüz J, Siemiatycki J, Tynes T, Woodward A, Yamaguchi N, Cardis E. Quantifying the Impact of Selection Bias Caused by Nonparticipation in a Case–Control Study of Mobile Phone Use. Ann Epidemiol 2009; 19:33-41. [DOI: 10.1016/j.annepidem.2008.10.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2008] [Revised: 10/07/2008] [Accepted: 10/07/2008] [Indexed: 10/21/2022]
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Schmidt-Pokrzywniak A, Jöckel KH, Bornfeld N, Sauerwein W, Stang A. Positive interaction between light iris color and ultraviolet radiation in relation to the risk of uveal melanoma: a case-control study. Ophthalmology 2008; 116:340-8. [PMID: 19091418 DOI: 10.1016/j.ophtha.2008.09.040] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2008] [Revised: 09/22/2008] [Accepted: 09/24/2008] [Indexed: 12/23/2022] Open
Abstract
PURPOSE To examine the association among phenotypic characteristics, chronic and intermittent ultraviolet (UV) radiation, and the risk of uveal melanoma. DESIGN Case-control study. PARTICIPANTS Overall, between September of 2002 and March of 2005, 1677 eligible subjects (age range: 20-74 years, living in Germany) participated. Interviews were conducted with 459 incident uveal melanoma cases (response proportion 94%), 827 population controls (55%), 180 ophthalmologist controls (52%), and 187 sibling controls (57%). METHODS Data on phenotypic characteristics and chronic and intermittent UV radiation exposure were obtained from a self-administered postal questionnaire and computer-assisted telephone interview. We used conditional logistic regression to estimate odds ratios adjusting for the matching factors. Furthermore, we studied the presence of synergy (super additive of risk or relative excess risk due to interaction) between light iris color and several UV radiation exposures. MAIN OUTCOME MEASURES Hair color at age 20 years, eye color, untanned skin color, ability to tan, propensity to burn on exposure, freckling, occupational sun exposure, artificial UV radiation, burns to the eyes. RESULTS In all 3 control groups, fair skin color, freckling as a child, nevi on the upper arms, burns to the eyes, use of sunlamps, and ever worked outside for 4 or more hours per day were positively associated with uveal melanoma. The association with eye color was apparent only in population controls (odds ratio = 1.9; 95% confidence interval [CI], 1.4-5.2), resulting in a relative excess risk due to interaction of 0.9 (95% CI, -0.6-2.3) for light iris color and more than 5 eye burns (UV-related keratitis) and 0.6 (95% CI, -0.3 to 1.5) for light iris color and eye protection. CONCLUSIONS Our interaction analyses suggest that there is an etiologic synergism between light iris color and the exposure of UV radiation. People with light iris color may have an especially increased risk for uveal melanoma if they are exposed to UV radiation. FINANCIAL DISCLOSURE(S) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- Andrea Schmidt-Pokrzywniak
- Clinical Epidemiology Unit, Institute of Medical Epidemiology, Biometry and Informatics, Medical Faculty, University of Halle-Wittenberg, Halle, Germany.
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Liese AD, Liu L, Davis C, Standiford D, Waitzfelder B, Dabelea D, Bell R, Williams D, Imperatore G, Lawrence JM. Participation in pediatric epidemiologic research: the SEARCH for Diabetes in Youth Study experience. Contemp Clin Trials 2008; 29:829-36. [PMID: 18573350 DOI: 10.1016/j.cct.2008.05.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2008] [Revised: 05/28/2008] [Accepted: 05/30/2008] [Indexed: 01/28/2023]
Abstract
BACKGROUND We evaluated the association of demographic and clinical characteristics with participation in an epidemiologic study of diabetes mellitus among youth. METHODS SEARCH for Diabetes in Youth is a multicenter study of physician-diagnosed diabetes in youth under the age of 20 comprising a surveillance and a cohort component. At each center, we enumerated all prevalent cases of diabetes in 2001 (n=6266) and all incident cases between 2002 and 2004 (n=3668). After confirmation of eligibility and validation, we invited each case to complete a survey and participate in a study visit. Here we evaluate how age, sex, race, and diabetes type are associated with participation in the survey and study visit. RESULTS Among prevalent cases, participation in the survey was 68% and 41% in the study visit. Among 2002 to 2004 incident cases, participation varied for the survey (76%, 81%, and 82%) and study visit (52%, 60%, and 60%). In multivariate logistic regression analyses among all incident cases, older age was associated with a lower odds of participation in the study visit (15-17 vs. <10 years: OR 0.5, 95% CI 0.4-0.7; 18-19 vs. <10 years: OR 0.3, 95% CI 0.2-0.5), as was having type 2 diabetes vs. type 1 diabetes (OR 0.5, 95% CI 0.4-0.7) and being of African American race vs. non-Hispanic White (OR 0.6, 95% CI 0.4-0.8). Results were very similar among prevalent cases. CONCLUSIONS Elucidating the relationship between individual characteristics and participation is essential for evaluating nonresponse bias, correcting for it, and for planning and implementing recruitment strategies.
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Affiliation(s)
- Angela D Liese
- Department of Epidemiology and Biostatistics and Center for Research in Nutrition and Health Disparities, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.
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Goodman A, Gatward R. Who are we missing? Area deprivation and survey participation. Eur J Epidemiol 2008; 23:379-87. [PMID: 18409005 DOI: 10.1007/s10654-008-9248-0] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2007] [Accepted: 03/23/2008] [Indexed: 11/30/2022]
Abstract
This study investigates selective participation by area deprivation in two population-based, nationally-representative surveys of children aged 5-16 years in England. We analysed the English participants (N = 22,903) in the British Child and Adolescent Mental Health Surveys, conducted in 1999 and 2004. The surveys recruited parents, teachers and children, allowing us to calculate participation rates for all three types of informant, with particularly detailed analyses possible for parents. Area-deprivation was assigned using Indices of Multiple Deprivation, 2004. We found that parents, teachers and children from more deprived areas were all substantially less likely to participate, with participation 8-9% lower in the most deprived areas than in the least deprived areas. There was substantial heterogeneity in the effect of deprivation on different types of parental non-participation, with a strong association for overall non-contact but none for overall non-cooperation. Refusal to participate in response to opt-out letters showed the opposite gradient to all other forms of non-participation, with individuals from less deprived areas being more likely to opt out. These findings indicate that the deprivation level of area of residence predicts non-response in multiple types of informants, which may exacerbate bias when estimating the prevalence of health outcomes. Furthermore, the magnitude and the direction of this may depend on the recruitment method used. Differential response by area deprivation may therefore be worth measuring in any survey.
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Affiliation(s)
- Anna Goodman
- London School of Hygiene and Tropical Medicine, Keppel street, London, WC1E 7HT, UK.
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Klug SJ, Hukelmann M, Blettner M. Knowledge about infection with human papillomavirus: a systematic review. Prev Med 2008; 46:87-98. [PMID: 17942147 DOI: 10.1016/j.ypmed.2007.09.003] [Citation(s) in RCA: 165] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2007] [Revised: 08/29/2007] [Accepted: 09/05/2007] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Human papillomavirus (HPV) is a necessary cause of cervical cancer and genital warts. The aim of this systematic literature review was to provide an overview of knowledge about HPV infection among the public, students, patients and health professionals. METHOD PubMed searches were performed and the results of studies were reported by age, gender, study population, country, recruitment score and year of study conduct. The recruitment score covered the mode of recruitment, study size and response rate. RESULTS We included 39 studies published between 1992 and 2006 covering a total of 19,986 participants. The proportion of participants who had heard of HPV varied from 13% to 93%. Understanding that HPV is a risk factor for cervical cancer depended on whether the question was closed (8-68%) or open (0.6-11%). Between 5% and 83% knew about the association of HPV and (genital) warts. HPV was often mistaken with other sexually transmitted viruses. Health professionals and women had better knowledge about HPV than other participants. CONCLUSION Overall, the knowledge of the general public about HPV infection is poor. Efforts should be increased to give sufficient and unbiased information on HPV infection to the general public.
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Affiliation(s)
- Stefanie J Klug
- Institute of Medical Biostatistics, Epidemiology and Informatics, Hospital of the University of Mainz, 55101 Mainz, Germany.
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Vandenbroucke JP, von Elm E, Altman DG, Gøtzsche PC, Mulrow CD, Pocock SJ, Poole C, Schlesselman JJ, Egger M. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. PLoS Med 2007; 4:e297. [PMID: 17941715 PMCID: PMC2020496 DOI: 10.1371/journal.pmed.0040297] [Citation(s) in RCA: 2852] [Impact Index Per Article: 167.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2007] [Accepted: 08/30/2007] [Indexed: 02/06/2023] Open
Abstract
Much medical research is observational. The reporting of observational studies is often of insufficient quality. Poor reporting hampers the assessment of the strengths and weaknesses of a study and the generalisability of its results. Taking into account empirical evidence and theoretical considerations, a group of methodologists, researchers, and editors developed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations to improve the quality of reporting of observational studies. The STROBE Statement consists of a checklist of 22 items, which relate to the title, abstract, introduction, methods, results and discussion sections of articles. Eighteen items are common to cohort studies, case-control studies and cross-sectional studies and four are specific to each of the three study designs. The STROBE Statement provides guidance to authors about how to improve the reporting of observational studies and facilitates critical appraisal and interpretation of studies by reviewers, journal editors and readers. This explanatory and elaboration document is intended to enhance the use, understanding, and dissemination of the STROBE Statement. The meaning and rationale for each checklist item are presented. For each item, one or several published examples and, where possible, references to relevant empirical studies and methodological literature are provided. Examples of useful flow diagrams are also included. The STROBE Statement, this document, and the associated Web site (http://www.strobe-statement.org/) should be helpful resources to improve reporting of observational research.
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Affiliation(s)
- Jan P Vandenbroucke
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Erik von Elm
- Institute of Social & Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Department of Medical Biometry and Medical Informatics, University Medical Centre, Freiburg, Germany
| | - Douglas G Altman
- Cancer Research UK/NHS Centre for Statistics in Medicine, Oxford, United Kingdom
| | | | - Cynthia D Mulrow
- University of Texas Health Science Center, San Antonio, United States of America
| | - Stuart J Pocock
- Medical Statistics Unit, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Charles Poole
- Department of Epidemiology, University of North Carolina School of Public Health, Chapel Hill, United States of America
| | - James J Schlesselman
- Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, and University of Pittsburgh Cancer Institute, Pittsburgh, United States of America
| | - Matthias Egger
- Institute of Social & Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Department of Social Medicine, University of Bristol, Bristol, United Kingdom
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